EnComPaSS project (Enhanced Community Palliative Care Support Services)

NIHR CLAHRC Yorkshire and Humber (NIHR CLAHRC YH) are working in partnership with Sensory Technologies a Canadian corporation to translate their E-shift service model for nursing palliative care patients, into the UK health market. E-Shift is a technologically enabled model of delegated nursing care, that allows qualified nurses to support non-qualified staff in delivering home care to a range of patients at ‘end of life’ through mobile and web based interfaces.

The partnership had a particular focus on applying the model to Palliative Care settings, both in the community and in care homes. The potential for this translation is being supported and evaluated by the NIHR CLAHRC YH in partnership with St Luke’s Hospice, Sheffield. CLAHRC YH has also established a Palliative Care Innovation Network for the region the purpose being to develop a research and implementation portfolio with our partner organisations. Following the successful brokerage by the NIHR CLAHRC YH, between the SME and the NHS, the company has set up its first European office in Sheffield, providing inward investment to the Yorkshire and Humber region. The company intends to use the UK base as a gateway to Europe.


Following the successful brokerage between the NHS, commissioners and Palliative care hospices in the region, the CLAHRC YH has submitted a ‘Nursing Technology’ application in partnership with St Luke’s Hospice in Sheffield. If successful this will provide funding to support the implementation of the technology within the Sheffield palliative care pathway.
CLAHRC academics have also submitted a bid to Marie Curie to research the novel use of the e-shift technology within care home in the city. This feasibility study will, if successfully funded, provide the information necessary to scale up the study to a definitive RCT, funding for which will be sought from the HS&DR funding stream.
CLAHRC academics are working with the AHSN in YH, Sensory Technology and the new Palliative Care Network in the region to submit a Horizon 2020 application within the Public Health Challenge 24 domain. Partners in Europe will be France, Luxemburg and Poland the aim being to implement the e-shift technology at scale utilising the Ready Steady Go tele health tool kit developed by NIHR CLAHRC Yorkshire and Humber. 

Project Team

Dr Deborah Fitzsimmons (project lead) dfitzsi4@uwo.ca
Professor Sue Mawson (project lead) s.mawson@sheffield.ac.uk
Dr Steven Ariss s.ariss@sheffield.ac.uk

The English End of Life Care Strategy identifies that palliative care in England is still largely regarded as “an optional extra”, and that the NHS relies heavily upon charities, including hospices, to deliver specialist palliative care. Delivery of an effective and efficient high quality palliative care service continues to be a challenge. Following our own extensive stakeholder engagement, our community partners have identified that finding a way to provide high quality, yet affordable, palliative care in the community is of key importance to them.

Project Summary
The Palliative and end of life care Priority Setting Partnership has recently published a report drawn from extensive public and practitioner engagement, identifying high priority research questions regarding the delivery of palliative care. Some of the top ten questions identified include:
1.    What are the best ways of providing palliative care outside of working hours to avoid crises and help patients to stay in their place of choice; 
2.    How can access to palliative care services be improved for everyone regardless of where they are in the UK;
3.    How can it be ensured that staff, including healthcare assistants, are adequately trained to deliver palliative care, no matter where the care is being delivered; and

4.    What are the benefits, and best ways, of providing care in the patient’s home and how can home care be maintained as long as possible.

This project will examine one potential answer to these questions.Research Question:
This research will address the following research question: can an internationally proven model of care provide an economic, efficient and effective model for delivery of community-based palliative care in England. Following the National Institute of Health Research (2006) definition, the purpose of this feasibility study is to test the pre-requisites needed to design a randomized controlled trial (RCT) of an intervention to provide specialist palliative care services through remotely supported Assistant Practitioners.

This feasibility study is designed to:
1.    Explore the definition of palliative care need and the criteria for referral to palliative care services across all disease categories;
2.    Determine how the intervention can be most effectively deployed within the UK;
3.    Assess the number of Assistant Practitioners a specialist nurse can manage remotely;
4.    Evaluate experience of the intervention with patients, family members and care providers;
5.    Assess IT readiness/ability of care workers before and after training; and
6.    Determine the best way to provide required training for Assistant Practitioners and specialist RNs;
7.    Determine how potential benefits can best be measured in a definitive Cluster Randomised Trial;
8.    Examine how the model change palliative care experiences;
9.    Identify important elements and conditions for effective implementation (causal mechanisms); and
10. Identify key issues around recruitment and retention of participants to the study.

Encompass presentation London

Moving towards an Enhanced Community Palliative Support Service (EnComPaSS): protocol for a mixed method study Sam Kyeremateng (Medical Director, St Luke's Hospice, Sheffield and Consultant) and Judith Park (deputy chief executive and director of patient care at St Luke's Hospice Sheffield, Chair of executive clinical leaders in hospice palliative care group) from St Luke's Hospice present at the Hospice UK 2015 Annual Conference.

They speak about the EnComPaSS project (Enhanced Community Palliative Care Support Services). this project aims to provide a cost effective model of care for patients who require palliative care. The model enables the patient to die in their home rather than a hospital whilst still receiving the care they need.The presentation can be viewed here:

Project Partners

CLAHRC partner organisations:

Rotherham, Doncaster and South Humber NHS Foundation Trust
Sheffield Health and Social Care NHS Foundation Trust
University of Sheffield
Sheffield Hallam University
Other partner organisations:
St Luke’s Hospice, Sheffield
Sensory Technologies Ltd, Canada
Chesterfield Royal Hospital
Marie Curie Hospice, Bradford
Marie Curie Cancer Care
Dynamic Health Systems Ltd 
University of Western Ontario, Canada