{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:26:43Z","timestamp":1787506003835,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR206122"],"award-info":[{"award-number":["NIHR206122"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim(s)<\/jats:title>\n                    <jats:p>To evaluate adult palliative and end\u2010of\u2010life care provision in England by community health nursing services using a national dataset (2013\u20132024) to report patterns in service provision over time and a regional dataset (2022\/23, 2023\/24 and 2024\/25) to describe palliative and end\u2010of\u2010life care activities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Secondary analyses of existing national and regional datasets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used national data to evaluate the populations served; workforce; referrals; unique service users seen annually; contacts; time on caseload; care delivered\/care locations; support to other teams\/processes; and deferred care. Regional data was used to examine palliative and end\u2010of\u2010life care activities in the context of all nursing care delivered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nationally, referrals to community health nursing services increased steadily from\u00a0~4,000 to ~6,000 per 100,000 weighted population between 2013 and 2024, while unique service users remained stable (around 2,600\u20132,800). Median average time on caseload reduced markedly from over 150\u2009days to around 50\u2009days, despite stable contact frequency (median 23 total contacts per service user) and duration (median 28\u2009min\u00a0for face\u2010to\u2010face contacts). Regional data showed that palliative and end\u2010of\u2010life care consistently accounted for 9.6% of all community nursing clinical time (30\u201332\u2009h per 1,000 population annually) across 3\u2009years, even as total care hours declined. A disproportionate amount of palliative and end\u2010of\u2010life care occurred out\u2010of\u2010hours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Increasing referrals and shorter time on caseloads indicate a system under pressure. Time spent on palliative and end\u2010of\u2010life care by community health nursing teams has remained stable over time, despite growing population need. Workforce capacity, skill mix and out\u2010of\u2010hours provision need to align to support high\u2010quality, person\u2010centred care in the community.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>This evidence informs better planning to ensure sufficient provision and workforce in community health nursing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient and Public Contribution<\/jats:title>\n                    <jats:p>Patients, family carers and public members contributed to interpreting findings and implications for practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70476","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T11:12:27Z","timestamp":1786014747000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Contributions to Palliative and End\u2010of\u2010Life Care by Community Health Nursing Services: Improving Care Through National and Regional Service Evaluations"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6152-1940","authenticated-orcid":false,"given":"Sophie","family":"Pask","sequence":"first","affiliation":[{"name":"Wolfson Palliative Care Research Centre, Hull York Medical School University of Hull  Hull UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assem","family":"Khamis","sequence":"additional","affiliation":[{"name":"Wolfson Palliative Care Research Centre, Hull York Medical School University of Hull  Hull UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4101-4329","authenticated-orcid":false,"given":"Tina","family":"Jarrett","sequence":"additional","affiliation":[{"name":"Birmingham Community Healthcare NHS Foundation Trust  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6375-0023","authenticated-orcid":false,"given":"Joanna M.","family":"Davies","sequence":"additional","affiliation":[{"name":"Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0034-7402","authenticated-orcid":false,"given":"Catherine J.","family":"Evans","sequence":"additional","affiliation":[{"name":"Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation King's College London  London UK"},{"name":"Sussex Community NHS Foundation Trust  Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1289-3726","authenticated-orcid":false,"given":"Fliss E. M.","family":"Murtagh","sequence":"additional","affiliation":[{"name":"Wolfson Palliative Care Research Centre, Hull York Medical School University of Hull  Hull UK"},{"name":"Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"First Assessment: A Review of District Nursing Services in England and Wales","author":"Audit Commission","year":"1999"},{"key":"e_1_2_13_3_1","volume-title":"Review of Palliative Care Services in Scotland. Report Supplement: District Nurse Survey","author":"Audit Scotland","year":"2008"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216317734435"},{"key":"e_1_2_13_5_1","doi-asserted-by":"crossref","unstructured":"Bowers B. 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