title: Specialist paediatric palliative care services: what are the benefits?
abstract: The number of children and young people (CYP) living with life-limiting and life-threatening conditions is rising. Paediatric palliative care is a relatively new aspect of healthcare, the delivery of which is variable, with a wide range of healthcare and voluntary sector providers involved. Policy recommendations are for Specialist Paediatric Palliative Care (SPPC) services to be supported by a physician with specialist training.
  
  
  
  To examine the research evidence regarding the distinct benefits of SPPC services, with 'Specialist Paediatric Palliative Care' defined as palliative care services supported by a specialist physician.
  
  
  
  Systematic review of studies of SPPC services published in English from 1980 to 2016. Keyword searches were carried out in medical databases (Cochrane, PubMed, EMBASE, CINAHL and AMED) and a narrative synthesis.
  
  
  
  Eight studies were identified, most of which were retrospective surveys undertaken within single institutions; three were surveys of bereaved parents and three were medical notes reviews. Together they represented a heterogeneous body of low-level evidence. Cross-cutting themes suggest that SPPC services improve the quality of life and symptom control and can impact positively on place of care and family support.
  
  
  
  Current evidence indicates that SPPC services contribute beneficially to the care and experience of CYP and their families, but is limited in terms of quantity, methodological rigour and generalisability. Further research is necessary given the significant workforce and resource implications associated with policy recommendations about the future provision of SPPC and to address the need for evidence to inform the design and delivery of SPPC services.
authors.affiliation: Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Sarah
authors.identifier: 0000-0002-1477-7860
authors.initials: S
authors.lastname: Mitchell
authors.affiliation: Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Morris
authors.affiliation: Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Karina
authors.initials: K
authors.lastname: Bennett
authors.affiliation: Sibling Council, Acorns Children's Hospice Trust, Birmingham, UK.
authors.forename: Laiba
authors.initials: L
authors.lastname: Sajid
authors.affiliation: Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Dale
mesh_terms: D002648:Child; D002662:Child Health Services; D006801:Humans; D010166:Palliative Care; D010372:Pediatrics
keywords: Paediatric Practice; Paediatric Staffing; Palliative Care