2004 - 2007 - Cicely Saunders Institute - King's College London

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Highlights
2007 is the 10-year anniversary of the founding of
the Department of Palliative Care and Policy, which
has grown in that time from a department comprising
Professor Irene Higginson and two researchers (both on
grant funding) to a large, multi-professional department
with well over 40 staff, plus many honorary and visiting
appointments. Although very saddened by the loss of
Dame Cicely Saunders in July 2005 we have continued
to drive forward her vision, through research, education,
care and, importantly, the plans to develop an institute
in her name.
Our research is mainly applied and translational
– concerned with discovering solutions to improve the
care, symptom management and support for those
affected by life threatening, progressive or profoundly
disabling conditions. In this regard, palliative care and
rehabilitation have much in common. Both specialities
seek to add quality of life to the time available (whether
in living with a disability or in dying), rather than finding
a ‘cure to a disease’. They seek to cure or reduce the
effects of symptoms, promote dignity and social and
emotional support. Both involve complex ‘interventions’
from a multidisciplinary team of professionals, and the
success of that intervention must usually be judged on
a background of deterioration in the person’s condition.
Thus, the two fields face similar research challenges.
This is reflected in our research activity where there is
the potential to learn from each other, and from other
fields, in the measurement of outcomes, in the design
of evaluations of complex interventions and in the future
in seeking potential solutions to symptoms, methods
and ways to promote dignity and support for carers. As
the remit of palliative care extends beyond cancer to
include people with other long term conditions, there is
an interface to be explored between rehabilitation and
palliative care services to support people who live their
lives with complex disability.
what factors influence whether people are able to
be cared for at home and to die at home, making an
important contribution to end of life strategies in many
countries. We have evolved several new strands of
research, particularly on palliative care in Africa, the
costs and benefits of rehabilitation, and improving
palliative care for older people. During the period of the
report, we have seen 53 MSc, Diploma and Certificate
students graduate, along with 3 successful PhD awards,
while continuing to evolve our undergraduate education
programme.
The following pages outline our research activity across
four main strands - evaluating and improving care;
symptom led research; measuring outcomes; and living
and dying in society. It outlines our influences on policy
and guidelines, educational and clinical activities, and
the plans for the new Institute of Palliative Care. Shortly
before her death, Dame Cicely Saunders was delighted
to see plans for her brainchild developing – to create
the world’s first purpose built Institute of Palliative
Care. At the end of the report we list publications,
keynote lectures and supporters, along with a full list of
staff. We are grateful to a wide range of collaborators
and colleagues with whom we work in research,
teaching, care and policy. Special thanks go to those
organisations, statutory and charitable, and individuals
that support our activities. In a climate where in the
UK less than 0.2% of the research spend in cancer
goes to palliative and end of life care, with probably
a lower proportion than this being allocated in noncancer
conditions, their leadership has been vital to our
continued work.
In the period of this report, 2004/5 to 2006/7, our
research, teaching and policy development have
advanced considerably locally, nationally and
internationally. We have seen the fuller integration of
palliative care and rehabilitation, especially as work
in palliative care grows to consider those people with
longer illness trajectories, with cancer, non-cancer
and multiple conditions. Our results have underpinned
some of the most significant national and international
guidance, including from the National Institute of
Clinical Excellence (NICE) in the UK, the State of the
Science Report on End of Life Care in the USA, the UK
Government White Paper on Our Health Our Choice
Our Lives, the House of Commons Health Committee
Report on End of Life Care and several National Service
Frameworks, including that on Long Term Neurological
Conditions in which Professor Lynne Turner-Stokes and
her team played a substantial role.
We have tested and discovered new means to improve
the management of symptoms, such as breathlessness
and spasticity, and have trialled new services for people
with conditions beyond cancer. We have discovered
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