System transformation in palliative and end of life care: developing a model for excellence
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 22 June 2021
Issue publication date: 13 October 2021
Abstract
Purpose
The purpose of this study is to report how the palliative and end of life care community in one region of England worked together to create a new model for integrated palliative and end of life care to respond to the challenges of changing demography, the need to reduce unnecessary hospital admissions of people nearing the end of life and to improve the quality of provision in line with current policy.
Design/methodology/approach
A co-production approach to system transformation was adopted involving 73 members of the palliative and end of life care community in one region of England.
Findings
A new model for the delivery of integrated palliative and end of life care services was produced. The breadth of membership of the co-production working party and constructive/collaborative working helped ensure a viable model was produced.
Practical implications
Although systems’ thinking perspectives can help address the challenges of large-scale transformation because they focus on promoting the value of relationships, recognise the nuances of context and the need to understand system behaviour over time, the potential for systems to benefit from this approach is limited by the complexity of the processes involved and the sheer number of issues to be addressed in practical terms by policy makers and change leaders.
Originality/value
The paper explores the contribution that theories of large-scale transformation can make to the design of palliative and end of life care services in health and social care.
Keywords
Acknowledgements
The authors are extremely grateful to all the members of the BSol Co-ordinated End of Life Care Working Party, who contributed to the development of the model reported in this paper.
Citation
Hewison, A., Hodges, E., Balasubramanian, S. and Swani, T. (2021), "System transformation in palliative and end of life care: developing a model for excellence", Journal of Health Organization and Management, Vol. 35 No. 8, pp. 1008-1024. https://doi.org/10.1108/JHOM-06-2020-0232
Publisher
:Emerald Publishing Limited
Copyright © 2021, Emerald Publishing Limited