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Borgstrom, Erica; Henry, Claire; Jordan, Joanne and St Ledger, Una (2023). Realising the Ambitions: Insights from how People Understand, Interpret and Implement the Ambitions Framework for Palliative and End of Life Care. The Open University, Milton Keynes, UK.
Abstract
The Ambitions for Palliative and End of Life Care: a national framework for local action (2021-2026) provides guidance on how to improve palliative and end of life care. It is incorporated into the statutory
guidance for Integrated Care Boards (ICB) and has informed service developments since 2015. This project used a multi-stage design to learn from case studies, focus groups and workshops. It focused on how people understand, interpret, and implement the Framework – how they make sense of it to inform action.
We found three ways as to how people operationalise the Framework in their work. Some adopt it at a strategic level, some use it to address action around specific Ambitions, and some use it to complement
other work being done. Focusing on the foundations, rather than only the Ambition statements, was easier for people to identify actionable plans. People valued learning what works and how, including challenges faced, through the research events. Leadership and resources were deemed by participants as key to drive implementation. Leadership is not restricted to those in official positions of power, although is expected of ICBs and at national level.
Headline recommendations
Focus on the foundations to drive action. The Grab and Go Guide (Small Steps, Big Vision) from this project provides prompts for this.
Foster collaboration and partnership working, investing in relationship building and understanding others’ perspectives to enable a system wide approach.
Expand opportunities for sharing learning about the Framework and examples of practice.
Acknowledge how interactions of the Ambitions impacts action. The in-depth examination of community provides an example of this.
Raise awareness and knowledge of the Framework beyond palliative care services.