Co-development of a peer-to-peer intervention to support healthcare assistants’ delivery of hospice care at home.
Healthcare Assistants, Hospice-at-Home, Realist Review, Realist Evaluation, Peer Support, Workforce Wellbeing
Healthcare assistants play a crucial role in delivering care at home, but their job can often be complex, invisible and undervalued. They also have varying levels of access to support and education, which affects their wellbeing, job satisfaction, and may impact on the quality of care they provide and staff retention.
Our goal is to develop a peer-to-peer programme within healthcare assistants’ teams that will support them in the delivery of hospice care at home. We will do that together with healthcare assistants and those currently involved in their support and training.
This project will be divided into five work packages (WP).
In WP1, we will gather evidence from all types of literature to understand why, how, for whom, and in what circumstances a peer-to-peer intervention for staff is effective.
WP2 involves interviews with healthcare assistants and WP3 will involve interviews with their managers and others who provide direct support and training. The aim of WP2 and WP3 to identify needs, preferences for workplace support and learning, and barriers and facilitators relevant in the local contexts.
WP4 will consist of workshops where healthcare assistants and those involved in providing support and training to them, will help us to develop the peer-to-peer support program and plan how it will be delivered. This will involve creating a model for the intervention, based on what we learned in previous stages of how it works, for whom, and in what circumstances to support healthcare assistants’ delivery of hospice care at home.
In WP5, we will pilot the intervention in two hospice sites to assess how it will work in practice. This will help us develop recommendations for implementing the intervention and guide further research on feasibility and effectiveness.
Patient and Public Involvement (PPI) has been integral to the development and ongoing processes of this research project. Early discussions with PPI partners and healthcare assistants identified the need for a peer support intervention, shaping the research focus. PPI groups members (Voices4Care and Marie Curie Research Voices) contributed to refining the proposal, confirming its relevance and importance. Their input influenced the research questions, protocol development, and lay summary. They also highlighted key areas such as safety, person-centred care, and communication. PPI partners are members of the advisory group, involved in all research stages, including recruitment planning, materials development, and data analysis. Their contributions ensure the research remains patient- and carer-focused while also reflecting real-world practice and concerns.
Data Collection ongoing
Realist Review Sept 2024 – May 2025
Realist Evaluation May 2025 – August 2027
PhD Researcher:
Katarzyna A. Patynowska, Doctoral Research Fellow, Institute of Nursing and Health Research, Ulster University, Belfast, UK / Research Nurse, Marie Curie, Belfast, UK
Supervisory team:
Dr Felicity Hasson, Senior Lecturer, Institute of Nursing and Health Research, Ulster University, Belfast, UK
Professor Sonja McIlfatrick, Professor in Nursing and Palliative Care & Dean of the Doctoral College, Institute of Nursing and Health Research, Ulster University, Belfast, UK
Dr Tracey McConnell, Lecturer School of Nursing and Midwifery, Queen’s University Belfast, Medical Biology Centre, Belfast, UK
Additional members will be invited to join the advisory group as the project progresses, and discussions with potential contributors are currently underway. The composition of the group will be reviewed and amended as needed to ensure it remains representative and aligned with the evolving needs of the research.
HSC R&D Division, Public Health Agency EAT/5776/24
PROSPERO registration of the realist review: crd.york.ac.uk/prospero/display_record.php?RecordID=606133
Financial support has been offered from Marie Curie for open access publication of realist review protocol.
Patynowska KA, McConnell T, McAtamney C, Hasson F. ‘That just doesn’t feel right at times’ – lone working practices, support and educational needs of newly employed Healthcare Assistants providing 24/7 palliative care in the community: A qualitative interview study. Palliat Med. 2023:2692163231175990.
Patynowska KA, Fantoni R, McConnell T, Finucane A, Donnelly P, McAtamney C, Walpole G, Clemo J, Wynne N, Leone E, Hasson F. 21 Wellbeing of lone working Healthcare Assistants and its impact on staff retention in hospice care at home services.2024, British Medical Journal Publishing Group.
Fee A, Muldrew D, Slater P, Payne S, McIlfatrick S, McConnell T, et al. The roles, responsibilities and practices of healthcare assistants in out-of-hours community palliative care: A systematic scoping review. Palliat Med. 2020;34(8):976-88.
Kasia Patynowska
Patynowska-k1@ulster.ac.uk
BlueSky: @kpatynowska.bsky.social
X: @KPatynowska
LinkedIn: Kasia Patynowska
