Ambitions for Palliative and End of Life Care: Mapping Examples of Use in Practice

Borgstrom, Erica; Jordan, Joanne and Henry, Claire (2022). Ambitions for Palliative and End of Life Care: Mapping Examples of Use in Practice. The Open University, Milton Keynes, UK.


The Ambitions for Palliative and End of Life Care: a national framework for local action was originally released in 2015 and relaunched in 2021 for an additional five years. Developed through partnership, the Framework provides a vision for action focused on six ambitions underpinned by eight foundations. This report shares findings from a project about how people have used the Framework in England. It involved mapping exercise based on a survey to identify examples of practice of how the Framework.

There are examples of services using the Framework across England. The majority of examples came from hospice and/or specialist palliative care settings. Each person is seen as an individual (Ambition 1) was most frequently identified as a primary focus for services. Each community is prepared to help (Ambition 6) was least frequently identified as a primary focus. The report includes case studies for each Ambition; they have not been evaluated as part of this project and are therefore not presented as examples of ‘best practice’.

The Framework is most frequently being used to provide guiding principles and to support education and training. Examples of use in local policy, commissioning and developing business cases were also identified. Survey respondents identified the Framework as having a role in enabling a process of service development from strategic conception to practical delivery, although there are persistent concerns about how ambitions can be meaningfully operationalised, measured, and resourced.

Overall, the Framework appears to be well received by survey respondents. It is perceived to provide a shared language about what matters in palliative and end of life care.

There is appetite for further education and knowledge exchange about the Framework and how people have used it. More work could be done to embed the use of the Framework in local strategies and partnership development, as well as supporting initiatives to realise Ambition 6.

Suggested next steps include further research; encouraging the use of the Framework at strategy and commissioning levels; additional education, training and knowledge exchange; and focusing on carers and communities. Further in-depth case study analysis and additional research will be conducted by the project team starting in April 2022. This will focus on how a range of stakeholders understand, interpret, and implement the Framework.

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