Marie Curie, the UK’s leading end of life charity, has awarded funding to six new research projects aiming to improve palliative and end of life care in, and upon discharge from, hospitals.
The six projects address a range of issues from improving communication and advance care planning on discharge from hospital to community, to palliative care practices for people living with frailty.
Others explore the impact of new models for Emergency Department (ED) in-reach services on access to palliative care and investigate better treatment for patients with chronic limb-threatening ischaemia (CLTI) who currently have little access to palliative care.
One study, co-funded with Royal Brompton & Harefield Hospitals Charity and Leeds Hospitals Charity, taking place in Leeds, will investigate access to palliative care for people living with heart failure.The study, led by Dr Sam Straw, Honorary Cardiology Registrar at Leeds Teaching Hospitals NHS Trust, will explore how people living with heart disease nearing the end of life can be identified earlier and supported better.
More than one in 10 people over 70 have heart failure, and around a third of those who attend hospital will die within a year. Their palliative care needs are often unmet; only 7% of people with advanced heart failure are placed on a palliative care register in the UK, compared to 48% of those with advanced cancer, despite experiencing symptoms with similar severity. When admitted to hospital, only a small number of people with heart failure are identified as having palliative care needs and therefore receive it, leaving many without such support. When this care is offered, it is often too late to make a meaningful difference to patients and their families.
The research will examine how healthcare professionals can better identify people living with heart failure who may be nearing the end of life, with the use of a simple tool called the ‘Surprise Question’. This asks whether a clinician would be surprised if a patient were to die within a year. The answer may help in working out whether and when palliative care may be appropriate and helping clinicians act earlier to provide timely care.
Dr Sam Straw, NIHR Academic Clinical Lecturer in Cardiology at University of Leeds and Honorary Cardiology Registrar at Leeds Teaching Hospitals NHS Trust said:
“As clinicians, we know that people living with heart failure often experience symptoms as severe as those seen in many cancers, yet far too few are offered the supportive and palliative care that could really improve their quality of life. One of the key challenges is that heart failure can follow an unpredictable course, making it harder to identify when patients would benefit from additional support.
“This research will help us address this by giving clinical teams a simple, practical way to recognise needs earlier and start important conversations sooner. By embedding this approach into the specialist treatment and care that is provided in hospitals, we hope to ensure that more patients and their families receive the right support, at the right time, throughout their illness.”
The project will review existing evidence and bring together experts, people with lived experience and clinicians in Leeds to develop practical approaches to improving care, such as linking the Surprise Question to a structured needs assessment. The study will also assess whether these changes will lead to improvements in the care patients receive.
Dr Sabine Best, Associate Director, Research Management and Impact at Marie Curie, said:
“Too many people with conditions like heart failure miss out on the support they need at the end of life. This research will help build the evidence base on how we can identify people earlier and make sure everyone with palliative care needs receives high quality, coordinated care when it matters most - regardless of their illness, where they are or who- they are.
“While only 6% of people in England and Wales say they would prefer to die in hospital, more than 40% of deaths still occur there. All our newly funded projects aim to address important evidence gaps for palliative and end of life care in, and upon discharge from, hospital that have been highlighted by people with lived and professional experience. Our aim is for palliative and end of life care to reach more people, and to close the gap in end of life care.”
Rebecca Baldaro-Booth, Director of Grants and Impact, Leeds Hospitals Charity, said:
“Too many people are still missing out on the care and support they need at the end of life, and often individual needs are identified too late. Through this joint funding call, we’re investing in research that can help spot needs earlier, improve coordination between hospital and community care, and tackle persistent inequalities in access. By working alongside clinicians, researchers and people with lived experience, evidence can be turned into practical solutions that ensure everyone can receive high-quality, compassionate care when and where it matters most."
Dr Peter O’Donovan, Director of Programmes & Funding, Royal Brompton & Harefield Hospitals Charity, said:
“As a charity dedicated to advancing care for heart and lung patients, we often focus on funding new treatments and improving patient experience. But for those who do not recover, their end-of-life journey is just as important and deserves equal attention. We are proud to support this project, which aims to identify heart failure patients who may benefit from palliative and end-of-life care earlier, ensuring more people receive the support they need when at their most vulnerable.”
This study is supported by NIHR Clinical Research Facility: Leeds and NIHR Biomedical Research Centre: Leeds. It will commence in Summer 2026 involving patients and clinicians at Leeds Teaching Hospitals.
Marie Curie is the largest charitable funder of palliative and end of life care research in the UK. Through funding projects like this, the charity aims to improve care for people living with serious illness and support better experiences at the end of life.
To find out more about the funded projects, visit https://www.mariecurie.org.uk/research-and-policy/research/research-grants-scheme-hospitals