Challenges in resource planning as a barrier to patients achieving death at home

Introduction Evidence suggests that the majority of patients wish to die at home. However, this is only attainable for few. Aim To identify the barriers and facilitators to being able to die at home in the UK. Methods: A two-step study approach was adopted. 1 A systematic literature review (SLR) and 2 primary qualitative data collection. In the SLR 3241 papers were retrieved. 72 articles remained after screening and filtering processes. Qualitative articles were analysed using meta-ethnography and quantitative articles were analysed using a descriptive approach. In the primary study, 33 in-depth interviews were conducted with experts in end-of-life care. Thematic Analysis of interview transcripts was conducted. Approval from Imperial College Research Ethics Committee was obtained for the study. The results from the SLR and primary data collection were amalgamated to produce a set of overarching barriers and facilitators. Results Six barriers and four facilitators were identified. The specific barrier of ‘challenges in resource planning’ will be discussed in this paper. This overarching theme included logistical issues in getting both the patient and equipment home, lack of continuity of care and geographic variation in resource provision, including 24/7 care. Conclusions Addressing this barrier could allow more patients to achieve death at home. However, it is important to acknowledge the qualitative nature of results. As a result, further research is required to identify the relative impact this barrier has on patients’ ability to achieve home death when compared to other barriers and facilitators identified.