Request for tenderIHF wishes to commission a literature review on existing published evidence on end-of-life service delivery models in the European and International landscape where carers provide out of hours support for people nearing end of life. About Irish Hospice FoundationIrish Hospice Foundation (IHF) is a national charity that addresses dying, death and bereavement in Ireland.
Our vision is an Ireland where people facing end of life or bereavement, and those who care for them, are provided with the care and support that they need.
Our mission is to work towards the best end-of-life and bereavement care for all.
Our values are integrity, courage, compassion, respect, and dignity. Background to this studyMost adults in Ireland say that they want to die at home. While not everyone can, nor should, die at home, Irish Hospice Foundation and age sector partners believe that more can be done to enable greater choice about place of care as death approaches. Irish Hospice Foundation are now expanding our work to support people who wish to die at home, their families and the professionals who provide end-of-life and palliative care at home through our new Dying Well at Home Programme. To inform the development of the Dying Well at Home programme, IHF conducted a series of focus group discussions with key stakeholders including members of the community who had experienced and provided support for people who chose to die at home. Research has shown that 74% of people in Ireland would want to die in their home (Enabling More People to Die at Home (Irish Hospice Foundation, 2014).
However, in 2017 only 23% of individuals in Ireland had home deaths.
This unmet need for end-of-life care in the home will increase as our population continues to age and grow.
Ireland is projected to have a 27% increase in number of deaths in a group of people in a certain period over the next 10 years. The National End of Life Survey (HIQA, 2024) is the first national survey asking bereaved people about the care provided to their relatives and friends in the last months and days of their life.
While this survey revealed positive experiences at end of life, overall areas for improvement identified were continuity, availability, and responsiveness of care; coordination between services and staff involved in care; and help and support for the emotional needs of the person who died.
Availability of a GP to visit out of hours was also identified as a significant challenge. Dying Well at Home Focus Group ReportTo better understand the experience of end-of-life care in the home in Ireland, IHF carried out a series of semi-structured focus group discussions with key stakeholders from November 2021 until November 2022.
These focus group discussions and interviews aimed to gather an in depth understanding from individuals, groups, organisations, and services about their experiences and views surrounding home-based end-of-life care.
The report identified a need for further discussions about out of hours care outside of 9am – 5pm Monday to Friday.
It was identified in the report the challenges and lack of available care for people outside these hours.
People become ill and can become sicker at any time of day or night, the lack of services outside these hours is extremely frightening for people, a huge risk, and also a burden for the skeleton staff who are left to cover these hours.
Irish Hospice Foundation's new Dying Well at Home Programme will endeavour to work towards bridging some of the gaps in services by working with its partners to develop resources and supports.
We are specifically interested in scoping out models care where carers provide out of hours support for people nearing end of life. Further reports identified these challenges which inform the need for this literature review:Irish Hospice Foundations Dying Well at Home Focus Group report (2023) The National End of Life Survey (HIQA, 2024) – Bereaved Relatives Experiences.Evidence and experience from Marie Curie on use of Health Care Assistants in end-of-life care, Felicity Hassan (2023).Specialist Palliative Care report of the Service Provision Out of Hours Working Group, 2023 (IHF Access).Time to Reflect, Irish Hospice Foundation (2024)National Adult Palliative Care Policy (DOH, 2024) ObjectivesTo identify and narrow down a number of countries that excel at providing good end- of- life care that have good service models of generalist care provided by carers that have the potential to be piloted in an Irish context.
The countries that must be included in the review would be the UK, Belgium, Netherlands, Sweden, Germany.
We would also like a review other European and International models as appropriate e.g.
Australia, Canada and USATo identify out-of-hours models of non-specialist (generalist) care for people nearing end of life, that have been successfully applied in a European Context with a particular focus on engaging carers to provide non-specialist careTo identify key factors and mechanisms that contributed to the success of identified models while also noting challenges and obstacles on models that did not succeed.To identify their impact and scalability of identified modelsPotential opportunities and challenges that will impact piloting of identified models in the Irish context ApproachThe methodology used to carry out the review must be systematic.
It should be rigorous in its identification of relevant key words/phrases and its sources used to locate relevant publications and other relevant outputs.
It should also evaluate the robustness of the evidence that it provides and take this into consideration in its presentation of findings and recommendations. Inclusion criteria:English languagePublication years –10 yearsAcademic databases for peer-reviewed literature, selected as appropriate (Pubmed etc.
)Including grey literature (national and regional health policies, working papers, international standards) Timeframe3 MonthsWe expect the work to commence 1st of November 2024 and completed by 1st of February 2025. DeliverablesA summary of the most relevant examples of research areas including key themes and target groups. We expect the full report to be approximately 10,000 words (excluding references) and written in a style suitable for its readership of IHF staff. The report should include an 'Executive Summary.' Further guidance on format of the report will be supplied nearer the time of its submission. This report will be used for internal publication and may inform later external publication with acknowledgement to the author.
IHF reserves the right to edit the final report in line with our own style guidelines. BudgetThe budget for this work will be a maximum of €7000 and must include VAT and other associated expenses. Assessment criteriaIn line with IHF procedures, applications will be assessed against the following criteria:Quality of proposed methodology and approach to the work in relation to IHF's aims for the workExpertise of the project team in relation to the methodologyRelevance of team's expertise in relation to knowledge about dying, death and bereavementTrack record in undertaking similar reviewsOverall quality of the proposalAccess to relevance databases and journals (both for Irish and European literature)Cost of the research Approach 40%Experience 40%Costing 20% For further informationPlease contact ****** for further information or if you have any queries in relation to the tender proposal. Submitting a tender proposalTo submit a tender to undertake this work please send your proposal by email to ****** by 5pm on the 2nd of October 2024. We will invite potential candidates to meet with us the week of the 9th Oct 24
