Review of national and regional datasets shows stable palliative care time in community nursing from 2013 to 2024

Aim(s) To describe adult palliative and end of life care provision by community health nursing services using a: {middle dot} National dataset (2013 - 2024) to report patterns in service provision over time {middle dot} Regional dataset (2022/23, 2023/24 and 2024/25) to describe palliative and end-of-life care activities. Design Secondary analyses of existing national and regional datasets. Methods We used national data to describe the populations served; workforce; referrals; unique service users seen annually; contacts; time on caseload; care delivered/care locations; support to other teams/processes; and deferred care. Regional data was used to examine palliative and end of life care activities in the context of all nursing care delivered. Results Nationally, referrals to community health nursing services increased steadily from 4,000 to 6,000 per 100,000 weighted population between 2013 and 2024, while unique service users remained stable (around 2,600 - 2,800). Median average time on caseload reduced markedly from over 150 days to around 50 days, despite stable contact frequency (median 23 total contacts per service user) and duration (median 26 minutes for face-to-face contacts). Regional data showed that palliative and end of life care consistently accounted for 9.6% of all community nursing clinical time (30 - 32 hours per 1,000 population annually) across three years, even as total care hours declined. A disproportionate amount of palliative and end of life care occurred out of hours. Conclusion Increasing referrals and shorter time on caseloads indicate a system under pressure. Time spent on palliative and end of life care by community health nursing teams has remained stable over time, despite growing population need. Workforce capacity, skill mix, and out of hours provision need to align to support high quality, person centred care in the community. Implications for the profession and/or patient care This evidence informs better planning to ensure sufficient provision and workforce in community health nursing. Patient and public contribution Patients, family carers and public members contributed to interpreting findings and implications for practice.