Ambitions for Palliative and End of Life Care: Research to Inform Realising the Vision

The Ambitions for Palliative and End of Life Care: a national framework for local action (2021-2026) provides guidance on how to improve palliative and end-of-life care and it is incorporated into the statutory guidance for Integrated Care Boards (ICBs). The framework was developed through partnership joining health and social care organisations with local authorities and third sector. It was first released in 2015 and since then, little is known about how it has been used to improve palliative and end-of-life care across the country. To address this gap, a team based at The Open University (Erica Borgstrom, Joanne Jordan, Claire Henry MBE, and Una St Ledger) conducted two related projects to examine how people understand and use the Ambitions Framework.

The first project mapped the existing use of the Framework. This was funded by NHS England and NHS Improvement. The team surveyed examples of practices, receiving 45 responses from across the UK. The majority of examples came from hospice and/or specialist palliative care settings. Each person is seen as an individual (Ambition 1) was most frequently identified as a primary focus for services.  Each community is prepared to help (Ambition 6) was least frequently identified as a primary focus. A key finding was that people found the Ambitions provided a shared language to talk about quality palliative and end-of-life care but lacked clear direction on how to realise the vision within the framework. The team produced a report including case studies for each Ambition; anonymised data is available for other researchers.

The second project sought to delve deeper into how people make sense of and use the Ambitions Framework. The project was funded by Marie Curie and used a multi-stage design to learn from case studies, focus groups and workshops. We found three ways as to how people operationalise the Framework in their work. Some adopt it at a strategic level, some use it to address action around specific Ambitions, and some use it to complement other work being done. Focusing on the foundations, rather than only the Ambition statements, was easier for people to identify actionable plans. The project team therefore created a Grab-and-Go guide, refined through Evidence Cafes, to help people focus on the foundations and link them to their areas of practice or service.- Read our full second project report

Get your copy of the Grab-and-go guide Small Steps, Big Vision

This version of the guide provides you and your organisation prompts to think about the foundations that underpin the Ambitions. For each foundation, it provides examples of action and practice to inspire your own local improvements. It was designed with commissioners, managers, and health and social care teams in mind, but it can also be used by charities and research teams.

Get your copy of the customisable guide Small Steps, Big Vision

This version of the guide enables you to customise the examples to have a sharable, locally-informed document. This is useful for partnership working, documenting outcomes of mapping meetings, and providing a record for monitoring improvements. If you’re willing to, you can share your version with us so we can learn how people use it and to inform future work in this area.

We would love to hear how you use the report and guides to inform your practice.

If you’d like a member of the project team to speak to your organisation about the project or how to use the guide, please contact erica.borgstrom@open.ac.uk.