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Change in Activity of Palliative Care Services during the Covid-19 Pandemic: A Multinational Survey (CovPall)

Sleeman, Katherine E.; Cripps, Rachel L.; Murtagh, Fliss E.M.; Oluyase, Adejoke O.; Hocaoglu, Mevhibe B.; Maddocks, Matthew; Walshe, Catherine; Preston, Nancy; Dunleavy, Lesley; Bradshaw, Andy; Bajwah, Sabrina; Higginson, Irene J.; Fraser, Lorna K.; on behalf of the CovPall Study Team


Katherine E. Sleeman

Rachel L. Cripps

Adejoke O. Oluyase

Mevhibe B. Hocaoglu

Matthew Maddocks

Catherine Walshe

Nancy Preston

Lesley Dunleavy

Andy Bradshaw

Sabrina Bajwah

Irene J. Higginson

Lorna K. Fraser

on behalf of the CovPall Study Team


Objectives: To identify factors associated with palliative care services being busier during Covid-19. Methods: Cross-sectional online survey of UK palliative care services (April to July 2020) (CovPall). Ethical approval was received from King's College London Research Ethics committee (LRS-19/20-18541). The primary outcome was change in busyness (five-point ordinal scale). Ordinal logistic regression investigated factors associated with the primary outcome. Results: Of 277 responses, 71 (26%) reported being a lot more busy, 62 (22%) slightly more, 53 (19%) about the same, 50 (18%) slightly less, and 28 (10%) much less busy. Increased business was associated with homecare services (odds ratio [OR] 1.93, 95% confidence interval [CI] 1.15-3.25), nursing care at home (OR 3.24, 95% CI 1.70-6.19), publicly managed services (OR 2.20, 95% CI 1.11-4.34), Covid-19 cases (OR 1.01, 95% CI 1.00-1.01), and staff shortages (OR 2.71, 95% CI 1.64-4.48). Conclusion: Services providing community care, and publicly managed services, may have been better able to respond to escalating needs during Covid-19. This has potential implications for both service delivery and funding models.


Sleeman, K. E., Cripps, R. L., Murtagh, F. E., Oluyase, A. O., Hocaoglu, M. B., Maddocks, M., …on behalf of the CovPall Study Team. (2022). Change in Activity of Palliative Care Services during the Covid-19 Pandemic: A Multinational Survey (CovPall). Journal of palliative medicine, 25(3), 465-471.

Journal Article Type Article
Acceptance Date Nov 16, 2021
Online Publication Date Dec 20, 2021
Publication Date Mar 1, 2022
Deposit Date Jan 5, 2022
Publicly Available Date Jan 5, 2022
Journal Journal of palliative medicine
Print ISSN 1096-6218
Electronic ISSN 1557-7740
Publisher Mary Ann Liebert
Peer Reviewed Peer Reviewed
Volume 25
Issue 3
Pages 465-471
Keywords Covid-19; End-of-life care; Hospices; Palliative care; Pandemics; Severe acute respiratory syndrome coronavirus 2
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Published article (118 Kb)

Copyright Statement
© Katherine E. Sleeman et al., 2021; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of theCreative Commons License (CC-BY) (, which permits unrestricted use, distribution, and re-production in any medium, provided the original work is properly credited.

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