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Roles and responsibilities of the community palliative care key worker: a scoping review

02 August 2022
17 min read
Volume 27 · Issue 8

Abstract

This article illustrates the completion of a scoping review of the evidence relating to the role of the palliative care key worker, providing an insight into current literature. While advocated in international and national policies, the evidence underpinning this role is lacking, with only five empirical papers: two national and three international. The review identifies the need for the key worker role in palliative care; however, little consensus exists on who should adopt this role and their remits. Several implementation barriers are cited relating to communication and training. Further research on the development, implementation and consensus on the allocation of duties of the key worker role would expand the existing evidence base.

Internationally, the role of the key worker was introduced to enhance patient-centred care and is a fixture across health and social care systems (Brogaard et al, 2011; International Association for Hospice and Palliative Care, 2019a). Since its first description by the World Health Organization (WHO) in 2016, there has been little evidence of the implementation of a clear definition of this role across the globe. Without standardisation, the title, role and function vary accordingly within and across countries and professions (Feuz, 2014; Hull and Turton, 2014). For example, in the UK, variance of key worker roles across clinical settings exist (Table 1).

There has been an upshoot in the demands faced by the palliative care sector globally (Centeno and Arias-Casais, 2019) and nationally (von Petersdorff et al, 2021) for its services rendered. However, there is a need for coordination to meet such demands. Within palliative care, the key worker is described as a professional whose key responsibilities are the planning and coordination of care of patients requiring end-of-life care, with an aim to maximise their quality of life (Palliative Care in Partnership, 2017). Generally, they are based in the community care setting and are responsible for engaging with patients and their families while sharing information with the wider multidisciplinary team (Gold Standards Framework, 2009). They can also develop therapeutic relationships with the patient and their family to become an effective advocate before deterioration, thus facilitating shared decision–making. This also allows the key worker to network with other services (including voluntary) to help provide the tools for the best quality of life before death (Department of Health (DH), 2010; Health and Social Care Board, 2017).

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