Developing the model of care and the co-design and option appraisal process

The North West London (NW London) Community Specialist Palliative Care (CSPC) Model of Care Working Group was asked to develop and co-design .a new Model of Care for CSPC services for adults (18+) only.

This new model of care will aim to make sure people get the right care at the right time, by the right team in the right place. It also aims to ensure that patients with a life limiting illness, their families, carers and those important to them have equal access to high quality community-based specialist palliative and end of life care and support that is sustainable and coordinated, and which from diagnosis through to bereavement reflects their individual needs.

We would like to thank all the members of the NW London CSPC Model of Care Working Group and the wider patients, families, carers and other stakeholders for their feedback and suggestions that are so integral for the success of this programme.

The NW London CSPC Model of Care Working Group has been meeting weekly since May 2022, receiving background evidence and information, including all the wonderful and insightful feedback we received through our engagement and which is detailed in the Engagement Outcome Report and we have heard what they have said is important to them.  Whilst the work of the NW London CSPC Model of Care Working Group is ongoing they have so far:

  • Discussed what good community-based specialist palliative care should look like and what the future capacity and demand for these services will be.
  • Co-designed the over-arching principles which will underpin the overall design of future community-based specialist palliative care services in NW London for the next five years.

These principles are designed to work in co-ordination with principles that have been developed to support the provision of community-based specialist palliative care.  We have developed an options development process to build on this work as we move towards making specific recommendations for services.

This appraisal process is transparent and robust and will allow us decide between different options and to develop a preferred way forward that addresses all the issues as laid in the Issues Paper that was published in November 2021.

This strong appraisal process will help us:

  • Give due consideration of all options
  • Reduce the options to a manageable number as quickly as possible
  • Support the weighing up of different options
  • Can be completed as simply as possible

Diagram one shows how the appraisal process will work.

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  • The NW London CSPC Model of Care Working Group will generate an initial list of options for delivery of the future model of care.
  • We will be asking members of the public and other stakeholders to help us generate a long list of options.
  • It’s important to note that all suggestions can be included in the long-list whether feasible or not.


  • Long-list of options is analysed by NW London CSPC Steering Group using ratified hurdle criteria which determines which options are feasible.
  • Short-list of fewer options is then generated and these are taken forward for further analysis


  • Short list of options undergoes in-depth assessment by the NW London CSPC Appraisal Task and Finish Group that is set up specifically to do this.
  • Membership will consist of NW London stakeholders as well as independent external stakeholders, including patient/carer representatives.
  • Using appraisal criteria, they will reduce the short-listed options to a list of recommendations that will go to public consultation if that is deemed to be needed.
  • The recommended options will be agreed, including a preferred option, by the NW London CSPC Steering Group.

Following the appraisal process, we will then work with our Borough Based Partnerships, local residents and palliative and end of life care stakeholders to decide whether the new service standards can be delivered by existing service structures or whether a service change is needed. If it is deemed that substantial service change is needed, we will then need to consider if a public consultation is necessary.  If consultation is needed the options will then go into the pre-consultation business case.

This is not a plan to replace work that is already going on. It is a plan to build on the on-going commitments in NW London for community-based specialist palliative care and identify where there are gaps and opportunities.

We welcome your feedback on the approach outlined above. Please email

For further information about the development of the model of care and the shortlisting appriasal process click on the boxes below.

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