The RE-EQUIPP Care Partnership: REducing inEQUalities through Integration of Primary and Palliative Care

Research question: How can innovative integrated whole-system models of cross-boundary primary and palliative care reduce inequalities in access to high quality palliative care? Background

The number of people dying at home has increased by 39% during the COVID-19 pandemic. Inequalities in access to palliative care for people with multi-morbidity and those from areas of high socioeconomic deprivation and diversity, and rural areas, persist. Primary care (including general practitioners and community nurses) provide the majority of palliative and end-of-life care in the community and have a key role in addressing longstanding inequalities, alongside palliative care services.

However primary care receives little attention in palliative care policy, and cross-boundary primary and palliative care research is rare.

This new multiagency and multidisciplinary partnership will lead high quality, collaborative primary and palliative care research proposals to address the gap in the current evidence and inform effective integration of services. This is urgently needed as the number of people in need of end-of-life care in the community remains high and is projected to increase.

Aims The partnership has three main aims:

1. Infrastructure and involvement: to build a successful, sustainable, multidisciplinary and multisector “hub and spoke” model partnership between primary and palliative care research, patient and public involvement, and practice across three diverse geographical regions. The Cicely Saunders Institute, King’s College London will be the “hub”, buddying with Sheffield and Sussex as “spokes”;

2. Integration: to provide new insights and understanding into when and how effective integration between primary and palliative care services occurs, and who benefits

3. Inequalities: to provide new insights and understanding into how the integration of community, primary and specialist palliative care services can reduce inequalities. Partnership plan The planned partnership activities are:

1. To build patient and public involvement (PPI) infrastructure and capacity across the three sites, with a workshop to provide new insights into effective PPI, enabling PPI in Sheffield and Sussex by infrastructure expansion of the Cicely Saunders Institute online PPI forum for palliative care forum, and a PPI “Dragon’s Den” event to identify priorities and inform future research,

2. To run virtual research and practice workshops, taking a realist approach to provide new insight and understanding into integration and inequalities in palliative and end-of-life care, 3. To build palliative care research leadership through bespoke mentorship, and

4. To improve the infrastructure for policy-relevant research through the development of mechanisms for knowledge exchange with local, regional and national policy makers, including those in commissioning, professional bodies, voluntary sector and government. Timeline for delivery: 12 months Impact and dissemination

Impact will be achieved through the formation of this new partnership, which will build multi-disciplinary palliative and primary care research capacity and capability across England. Findings from the workshops will be published. The main outputs from this partnership will be a series of nationally competitive grant applications for Part 2 of this NIHR Commissioned call.