End-of-life care in the rural and coastal communities of the South West

A participatory realist evaluation
A small village on the coastal line in Cornwall [shutterstock_87644971]

End-of-life care in the rural and coastal communities of the South West

A participatory realist evaluation
We are currently working with a wide range of stakeholders including patients, carers, health and care professionals, and volunteers. If you're interested in being involved or learning more about the study, please contact us at sweolstudy@plymouth.ac.uk
Title: Care of people at the end of their lives in the rural and coastal communities of the South West Peninsula of England: A participatory realist evaluation
Funding amount: £1,259,713.31
Location: South West Peninsula of England
Dates: October 2025 – January 2028
University of Plymouth CI: Dr Susie Pearce 
This project is led by the University of Plymouth in partnership with:
  • Local hospices and NHS organisations
  • Social care and VCSE partners
  • Researchers, clinicians, and PPI contributors across the region.
Care at the end of life in SW England logo
 

About the study

Around one in five people in England live in rural areas, where accessing health and care services can involve longer travel times, fewer transport options and greater distances between services.
This NIHR-funded study is exploring how care is provided to people approaching the end of their lives in rural and coastal parts of the South West of England – including Devon, Cornwall, the Isles of Scilly and Somerset.
People in these areas often face unique challenges in accessing healthcare services, and we want to understand what helps or hinders good end-of-life (EoL) care. We're working in partnership with local NHS, social care and voluntary organisations, and members of the public to explore what matters most and how care can be improved.

Aims of the study

  • Understand the experiences of patients, families, and professionals delivering EoL care in rural and coastal communities.
  • Explore the barriers and enablers to accessing and providing high-quality, compassionate care.
  • Generate practical recommendations for how care can be improved locally and nationally.
 

Method

Work package 1: Local case studies

We will undertake case studies in six geographical areas in Devon, Cornwall and Somerset, and six different populations. This will involve observations, focus groups, and interviews with patients, families, professionals, the voluntary sector, and those organising services.

Work package 2: Exploring the national context

We will survey people responsible for EoL care across the UK and interview local, regional, and national EoL leaders. We will conduct a systematic review of global innovations to address challenges to providing EoL care in rural and coastal areas.

Work package 3: Quantitative analysis of routine data

We will use existing NHS data, collected both nationally and locally, to explore and better understand reasons for difference in care during the last 12 months of life.

Work package 4: Data synthesis and co-design workshops

We will collate our findings from the first three work packages. Six workshops with patients, families, professionals and policymakers to reflect on findings and co-create recommendations.

Study progress

May 2026

The study team attended the SWP Regional Research Delivery Network (RRDN) Palliative Care Community of Practice Event in Exeter, which brought together colleagues working across the sector. It was a great opportunity to share updates and make further connections.
Dr Susie Pearce presented two posters at the European Association for Palliative Care (EAPC) Congress in Prague, where over 2,000
delegates from 79 countries attended. The posters helped to raise awareness of the project and provided an opportunity to engage with an international audience of researchers, clinicians and policymakers.

July 2026

We have completed two rounds of stakeholder workshops (with health and care professionals and family members) and are beginning data collection in some of our case study sites. 
We are working on a systemic review of the literature and conducting interviews with end-of-life leads across the country. We are finalising access and approvals for local and national data sets.

Read the newsletter

Download a copy of our newsletter for more updates on the study's progress.

 

Study team

  • Richard Harding SW EOL Study

    Professor Richard Harding

    Executive Dean, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Kings College London
  • Professor Mark Pearson SW EOL Study

    Professor Mark Pearson

    Professor of Implementation Science, University of Hull 
  • Professor Katrina Wyatt SW EOL Study

    Professor Katrina Wyatt

    Professor of Relational Health, University of Exeter Medical School
  • Dr Saskie Dorman SW EOL Study

    Dr Saskie Dorman

    Consultant in Palliative Medicine, Forest Holme Hospice, University Hospitals Dorset NHS Foundation Trust, Dorset Integrated Care System
  • Sam Ebden SW EOL Study

    Sam Ebden

    PPI Co-applicant, PPI Representative based in England
  • Sheena McCready SW EOL Study

    Sheena McCready

    PPI Co-applicant, PPI Representative based in England
  • Victoria Bartlett SW EOL Study

    Victoria Bartlett

    Director of Patient Care, Rowcroft Hospice
  • Simon Chant end of life study member

    Simon Chant

    Consultant in Public Health, Devon County Council

Outputs and impact 

We will be sharing our findings through:
  • Public and professional workshops
  • Conference presentations and academic publications
  • Practical recommendations for policy and service design
  • Resources to support compassionate and equitable care at the EoL.
Elderly man on a mobility scooter by the sea

Centre for Coastal Communities

Finding solutions to the challenges facing coastal communities
The University of Plymouth is one of the few UK Higher Education Institutions with a critical mass of academics with a proven track record of research on coastal communities. The Centre for Coastal Communities brings together researchers looking at coastal economic performance, deprivation, migration, educational underperformance, displaced populations, health and social care, the blue economy (renewable energy, fisheries, aquaculture, tourism, recreation and leisure), plastic pollution and economic, social and environmental policy for coastal communities.
 
Fishing nets