Charitably funded hospices and the challenges associated with the COVID-19 pandemic : A mixed-methods study (CovPall)

Garner, Ian and Walshe, Catherine and Dunleavy, Lesley and Bradshaw, Andrew and Preston, Nancy and Fraser, Lorna and Murtagh, Fliss and Oluyase, Adejoke O and Sleeman, K.E. and Hocaoglu, Mevhibe B. and Bajwah, Sabrina and Chambers, Rachel and Maddocks, Matthew and Higginson, IJ (2022) Charitably funded hospices and the challenges associated with the COVID-19 pandemic : A mixed-methods study (CovPall). BMC Palliative Care, 21: 176. ISSN 1472-684X

Abstract

Background: Independent charitably funded hospices have been an important element of the UK healthcare response to the COVID-19 pandemic. Hospices usually have different funding streams, procurement processes, and governance arrangements compared to NHS provision, which may affect their experiences during the COVID-19 pandemic. The aim of this study is to understand the challenges faced by charitably funded hospices during the COVID-19 pandemic. Methods: Eligible Organisations providing specialist palliative or hospice care completed the online CovPall survey (2020) which explored their response to the COVID-19 pandemic. Eligible organisations were then purposively selected to participate in interviews as part of qualitative case studies (2020-21) to understand challenges in more depth. Free-text responses from the survey were analysed using content analysis and were categorised accordingly. These categorisations were used a priori for a reflexive thematic analysis of interview data. Results: 143 UK independent charitably funded hospices completed the online CovPall survey. Five hospices subsequently participated in qualitative case studies (n = 24 staff interviews). Key themes include: vulnerabilities of funding; infection control during patient care; and bereavement support provision. Interviewees discussed the fragility of income due to fundraising events stopping; the difficulties of providing care to COVID-19 and non- COVID-19 patients within relatively small organisations; and challenges with maintaining the quality of bereavement services. Conclusion: Some unique care and provision challenges during the COVID-19 pandemic were highlighted by charitably funded hospices. Funding core services charitably and independently may affect their ability to respond to pandemics, or scenarios where resources are unexpectedly insufficient. Keywords: Charitably funded Hospice, COVID-19 Pandemic, Mixed-Methods Research, Funding constraints.