Ambitions for palliative and end of life care: a relentless focus on the person

Wee, Bee

doi:10.5750/ejpch.v5i4.1491

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…The remaining literature addresses the Framework in three main ways. First, editorials [9,10] and blogs [11][12][13] that summarise the aims and content of the Framework, typically highlighting its potential as a positive instrument for service change.…”

Section: How the Ambitions Framework Has Been Usedmentioning

confidence: 99%

Ambitions for palliative and end of life care: mapping examples of use of the framework across England

2023

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Background Since 2015, the Ambitions for Palliative and End of Life Care: a national framework for local action has provided guidance for care within England and beyond. Relaunched in 2021, the Framework sets out six Ambitions which, collectively, provide a vision to improve how death, dying and bereavement are experienced and managed. However, to date, there has been no central evaluation of how the Framework and its Ambitions have been implemented within service development and provision. To address this evidence gap, we investigated understanding and use of the Framework. Methods An online questionnaire survey was conducted to identify where the Framework has been used; examples of how it has been used; which Ambitions are being addressed; which foundations are being used; understanding of the utility of the Framework; and understanding of the opportunities and challenges involved in its use. The survey was open between 30 November 2021–31 January 2022, promoted via email, social media, professional newsletter and snowball sampling. Survey responses were analysed both descriptively, using frequency and cross-tabulations, and exploratively, using content and thematic analysis. Results 45 respondents submitted data; 86% were from England. Findings indicate that the Framework is particularly relevant to service commissioning and development across wider palliative and end of life care, with most respondents reporting a focus on Ambition 1 (Each person is seen as an individual) and Ambition 3 (Maximising comfort and wellbeing). Ambition 6 (Each community is prepared to help) was least likely to be prioritised, despite people welcoming the focus on community in national guidance. Of the Framework foundations, ‘Education and training’ was seen as most necessary to develop and/or sustain reported services. The provision of a shared language and collaborative work across sectors and partners were also deemed important. However, there is some indication that the Framework must give more prioritisation to carer and/or bereavement support, have greater scope to enhance shared practice and mutual learning, and be more easily accessible to non-NHS partners. Conclusions The survey generated valuable summary level evidence on uptake of the Framework across England, offering important insights into current and past work, the factors impacting on this work and the implications for future development of the Framework. Our findings suggest considerable positive potential of the Framework to generate local action as intended, although difficulties remain concerning the mechanisms and resources necessary to enact this action. They also offer a valuable steer for research to further understand the issues raised, as well as scope for additional policy and implementation activity.

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Section: How the Ambitions Framework Has Been Usedmentioning

confidence: 99%

Ambitions for palliative and end of life care: mapping examples of use of the framework across England

2023

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“…for FCGs in the patient's dying phase, acknowledging the importance of linking pre-death caring and post-death bereavement (Stroebe & Boerner, 2015;Wee, 2017).…”

Section: Family Caregiver (Fcg) Distress and Bereavement Outcomesmentioning

confidence: 99%

Exploring the “thin place” between life and death: Compassion-Focused Relational Music Therapy (CRMT) for terminal agitation in advanced cancer in a hospice setting

Binnie

2019

AIJMT

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Delirium and agitation are highly prevalent in the last days of life for cancer patients and can be distressing for patient, family and staff. Although guidelines recommend meticulous assessment of spiritual and psychological factors and a holistic response, in practice sedation is commonly used (particularly in hospital settings) in spite of ethical, professional and family ambivalence and mis-communication around this practice. A Compassion-Focused Relational Music Therapy (CRMT) approach proposes that the “thin place” between life and death can be explored and held within music, potentially reducing patient, family and staff distress (a ’triangular model of suffering’) and provide an important bridge between care-giving and bereavement. A mindful approach (breath, body-awareness, compassion) integrates with the use of ‘vocal holding’ and ‘lullament’ in order to support the elements of a ‘good death’; safety, peace, love, forgiveness and letting go. This article describes a case study of a CRMT intervention with a hospice patient dying from mesothelioma. It also presents a mixed-methods feasibility study research protocol.

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“…Editorials [ 4 , 5 ] and blogs [ 6 – 8 ] have endorsed the Framework and examples of its use are documented [ 9 – 11 ]. However, research evidence is limited.…”

Section: Introductionmentioning

confidence: 99%

Small Steps, Big Vision: using multi-stage qualitative research to develop a grab-and-go guide to support utilisation of the Ambitions for Palliative and End of Life Care framework

Borgstrom,

Jordan,

Ledger

et al. 2024

BMC Palliat Care

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Background The Ambitions for Palliative and End of Life Care is a national framework for local action in England co-produced by over 30 partners; little research has been conducted on how the Framework is received and used. This study sought to examine and support how people understand, interpret, and implement the Framework. Methods A multi-stage qualitative methodology involving four stages of data collection: (1) case study interviews, (2) focus groups, (3) interactive workshops, and (4) Evidence Cafés. From initial interviews, ongoing thematic data analysis informed the design and focus of subsequent stages as part of a process of knowledge transfer. Results A practical resource to support service provision and development was produced; a grab-and-go guide called “Small Steps, Big Visions”. It focuses on the eight foundations in the Ambitions Framework, with additional guidance on collaboration and partnership working, and sharing learning. Each foundation is presented with a ‘what’ (definition), ‘ask’ (prompt questions), and ‘examples in action’ (drawn from case studies). Conclusions Research can contribute to policy implementation to advance palliative and end of life care. The engagement and input of those responsible for implementation is key.

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Ambitions for palliative and end of life care: a relentless focus on the person

Cited by 4 publications

References 9 publications

Ambitions for palliative and end of life care: mapping examples of use of the framework across England

Ambitions for palliative and end of life care: mapping examples of use of the framework across England

Exploring the “thin place” between life and death: Compassion-Focused Relational Music Therapy (CRMT) for terminal agitation in advanced cancer in a hospice setting

Small Steps, Big Vision: using multi-stage qualitative research to develop a grab-and-go guide to support utilisation of the Ambitions for Palliative and End of Life Care framework

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