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Advance care planning in homeless people with multi-morbidity

A qualitative study

Dr Caroline Shulman, Principle Investigator - GP in homeless and inclusion health, Kings Health Partners and Pathway, Honorary senior lecturer, Marie Curie Palliative Care Research Department, Division of Psychiatry UCL, Caroline.Shulman@nhs.net, @carolineshulman.

Dr Briony Hudson, Research associate, Pathway and Marie Curie Palliative Care Research Department, Division of Psychiatry UCL, b.hudson@ucl.ac.uk @brionyhudson.

Peter Kennedy, former palliative care coordinator, St Mungo's.

Professor Paddy Stone, Marie Curie chair in palliative and end of life care, Marie Curie Palliative Care Research Department, Division of Psychiatry UCL.

Julian Daley, Expert by Experience and Care Navigator, Pathway.

Professor Julia Riley, Clinical Lead, Coordinate My Care, Palliative care consultant, Royal Marsden & Royal Brompton Palliative Care Service.

Dr Joe Low, Senior research fellow, Marie Curie Palliative Care Research Department, Division of Psychiatry UCL.

Dr Nigel Hewett, Medical director, Pathway, Secretary to the Faculty of Homeless and Inclusion Health.

This qualitative research study aims to explore how care and support for people who are homeless or vulnerably housed with complex health problems, and who may be approaching the end of their life, could be improved.

We will be investigating:

· The problems and issues associated with deteriorating health in this population from the perspective of homeless people, formerly homeless people, hostel and outreach staff and specialist health care providers.

· What homeless people and those involved in their care think about the end of life and palliative care services that are currently available.

· The complexities and barriers to delivering end of life care to this population and determine ways to improve services and support received.

· The training and support needs of people working with this group

As part of this research we are conducting a synthesis of the international qualitative literature.

We are also conducting interviews and focus groups with homeless people, formerly homeless people, hostel and outreach staff and specialist health care providers. These are taking place across Lambeth, Westminster and Hackney.

Using the information that we gather, we will make recommendations for how the care and services for homeless people with advanced ill health could be improved. We will also further develop the resource pack developed by Marie Curie and St Mungo's to support and extend training within hostels and for other professional groups.