Outcome Measurement in Palliative Care : Beyond the NICE Guidance

30th March 2006, London

NCPC’s first event on Outcomes in Palliative Care was hailed a success and much positive feedback was received from the delegates. Palliative Care cannot be exempt from objective measurement, but the challenge is how best to move forward in this challenging area and this event represents the starting point for more work in the future.

This national event highlighted many key learning points raised by our range of speakers:

• With specialist palliative care becoming a part of Payment by Results there is a greater need to demonstrate value for money in order to compete for resources.


• This means palliative care services need to develop effective mechanisms to demonstrate that they are:
• reaching those that need them most;
• cost effective;
• efficient and providing a high quality service.


• Different levels of outcome measurement are needed for different audiences. Providers, networks, commissioners and regulators will all have different needs and there may not be a ‘one size fits all’ measure.


• To adopt appropriate outcome measures for the future there is a need for both individual patient outcome measurement as well as aggregate, service level outcome measurement.


• Tools should also cater for response shift¹ – to be sensitive enough to
  pick up the changes people make to adapt to their situation through re-calibration², re-prioritisation³ or re-conceptualisation⁴.


• We need to identify, understand and involve service users at different stages of planning and development. There must be clarity of purpose and roles, with clear lines of accountability.


• The Health Care Commission are adapting their inspection process to a more outcomes focused approach for which palliative care will be a forerunner. Further details will be provided through a series of joint events which NCPC will be involved in.

Speakers’ presentations were complemented with round table discussions, generating many interesting discussion points and questions that NCPC will follow up.

Future Actions

NCPC has committed to produce a framework, for analysis of outcomes nationally and locally, and a document for wider discussion. NCPC will run more events on the progress made.

It was widely agreed that national guidance and training on outcome measurement was needed to ensure consistency throughout the country and NCPC is looking to work with others to address this need.

Speakers' Presentations:

Programme of the day   (155KB)

Professor Irene Higginson    (507KB)

Peter Tebbit   (45KB)

Jane Bradburn and Carolyn Morris   (290KB)

Alex Baylis   (423KB)

Professor John Ellershaw   (868KB)

Professor Jessica Corner   (430KB)

For any further information, please email Theresa Tsui, or telephone her on 020 7697 1520.

[1] Response shift describes how changing circumstances can lead to changes in how people assess their situation and view their life;

[2] Recalibration is adjustment of the impact of something (such as the level of pain) on the basis of personal experience;

[3] Reprioritisation is changing personal perception of the importance of different components of life in response to events;

[4] Reconceptualisation is jettisoning things that were previously personally important but are no longer attainable and therefore re-evaluating the importance of other aspects of life.