Using volunteers to improve access to community rehabilitation in palliative care: the St Christopher's Living Well at Home Team.
Gail Preston, Sanketh Rampes, Joanne Bayly and 4 others
PMID 37791372WHAT IT FOUND
Trained volunteers delivered supervised home rehabilitation for palliative patients who could not travel to the hospice.
Those who completed the programme reported better mobility, wellbeing, and goal achievement, suggesting a feasible way to extend care into homes.
Key findings
01Volunteers delivered supervised home rehabilitation to patients who could not access hospice outpatient services.
02Patients who completed the programme showed statistically significant improvements in mobility, wellbeing, and goal attainment.
03The programme extended rehabilitation reach to housebound patients without significant extra cost.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This was a service evaluation, not a randomised controlled trial, so it cannot prove the volunteers caused the improvements. Attrition was high: only 35 of 183 referred patients completed the programme, and outcomes data were missing for many participants. The study did not compare outcomes against usual care or a control group. Volunteers were not healthcare professionals, raising questions about the generalisability of the skill mix required for safe delivery.
Declared interests
Funded by a Hospice UK Major St James’s Place 2016 grant award and supported by the NIHR Applied Research Collaboration South London.
The easy way to misread this
Do not interpret the improvements as proof that volunteers alone deliver effective rehabilitation. The study lacked a control group, and the improvements were seen only in the small subset of patients who completed the programme under close clinical supervision.