Challenges for palliative care day services: a focus group study

Background: Palliative care day services provide a safe environment for people with palliative care needs, enabling
them to access a range of services while acting as a respite services for family caregivers. Viewed as marginal
services, they are often under resourced and under researched. The aim of this study was to understand how
palliative day care services contribute to client care from the perspective of management and hospice
multidisciplinary teams.
Methods: A descriptive qualitative study, using six focus groups conducted with staff at three United Kingdom
hospices in England, Scotland and Northern Ireland. Thirty-five participants were recruited, including management
and staff. Discussions were transcribed and analysed thematically.
Results: Four key themes emerged: (1) variations of care, beyond heterogeneity of patients; (2) unclear referrals and
inconsistent patient population; (3) recognising strengths and challenges and (4) an uncertain future. A major focus
of group discussions was the model of care and the benefits of the service, however the importance of
demonstrating services’ effectiveness and value for money was highlighted.
Conclusions: Management and hospice staff believed day-services to be a helpful introduction to palliative care,
providing both social and medical support. Economic pressures and patient demand were influencing them to
move from a social model to a hybrid model. Further research is needed to understand the effectiveness of the
service