The impact of covid-19 on out-of-hours adult hospice care: an online survey

F. Hasson, Paul F Slater, Anne Fee, Tracey McConnell, Sheila Payne, Dori-Anne Finlay, Sonja J McIlfatrick

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Background: Globally COVID-19 has had a profound impact on the provision of healthcare, including palliative care. However, there is little evidence about the impact of COVID-19 on delivery of out-of-hours specialist palliative care
services in the United Kingdom. The aim of the study is to investigate the impact of the COVID-19 pandemic on the delivery of out-of-hours community-based palliative care services.

Methods: A national online census survey of managers of adult hospices in the United Kingdom was undertaken. Survey were emailed to managers of adult hospices (n=150) who provided out-of-hours community palliative care services. Fifteen questions related specifically to the impact of COVID-19. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using descriptive content analysis.

Results: Eighty-one responses to the survey were returned (54% response rate); 59 were complete of which 47 contained COVID-19 data. Findings indicated that COVID-19 impacted on out-of-hours community-based palliative care. To meet increased patient need, hospices reconfigured services; redeployed staff; and introduced new policies and procedures to minimize virus transmission. Lack of integration between charitably and state funded palliative care providers was reported. The interconnected issues of the use and availability of Personal Protective Equipment (n=21) and infection control screening (n=12) resulted in changes in nursing practices due to fear of contagion for patients, carers and staff.

Conclusions: Survey findings suggest that due to increased demand for community palliative care services, hospices had to rapidly adapt and reconfigure services. Even though this response to the pandemic led to some service improvements, in the main, out-of-hours service reconfiguration resulted in challenges for hospices, including work‑force issues, and availability of resources such as Personal Protective Equipment. These challenges were exacerbated by lack of integration with wider healthcare services. More research is required to fully understand the implications of such changes on the quality of care provided.
Original languageEnglish
Article number94 (2022)
Pages (from-to)1-7
Number of pages7
JournalBMC Palliative Care
Issue number1
Early online date1 Jun 2022
Publication statusPublished (in print/issue) - 1 Jun 2022

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This research was funded by a research grant awarded to Dr Felicity Hasson by Marie Curie UK (REF MCRGS-20171219–8007).

Publisher Copyright:
© 2022, The Author(s).


  • COVID-19
  • pandemic
  • out-of-hours
  • palliative care
  • hospice
  • survey methodology
  • community care
  • Pandemics
  • Hospice Care
  • Humans
  • After-Hours Care
  • Hospices
  • COVID-19/epidemiology
  • Adult
  • COVID-19; pandemic; out-of-hours
  • Hospice
  • Palliative care
  • Community care
  • Survey methodology


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