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An economic evaluation of community services at St. Vincent’s Hospice

Brona McGee, Director of Care, and Dr Mairi-Clare McGowan, Consultant in Palliative Medicine, St. Vincent's Hospice

Brona and Mairi-Clare's case study was completed in 2019 and reflects 2019 prices

In order to ensure their services were addressing current need and in line with national policy, St Vincent's hospice in Howwood, Renfrewshire, commissioned a review of their community services. Six recommendations were proposed.

After exploring what a more integrated service might look like, Brona McGee, Director of Care and Mairi-Clare McGowan, Consultant in Palliative Medicine, St Vincent's Hospice, Howwood elected to focus their attention on two of the review recommendations. They developed proposals for service redesign in two distinct areas of their community services and applied the principles of economic assessment in each case. Whilst working as a team each took the lead in a specific area.

Brona focused on their bereavement /counselling service and using a cost-effectiveness approach compared the current one-to-one counselling service with a proposed hybrid approach incorporating both group support and one-to-one counselling options. Based on the assumption that the outcomes would be similar in each case and that the number of people accessing the service would remain the same, Brona demonstrated that her proposed service redesign was a more cost effective approach.

Mairi-Clare focused on the clinical nurse specialist community outreach service which currently provide specialist support and advice to patients and families affected by life-limiting conditions during normal working hours, Monday-Friday. The service-redesign and development proposed would maintain the benefits of the current service, extend its reach beyond those affected by cancer and further develop the range of support available to include hands-on practical support and carer respite a 7-days a week.

These ambitious plans would require investment so Mairi-Clare developed a costs consequence analysis and offered a range of options as to how these costs might be met.

You can contact Brona and Mairi-Clare by email: and

Case study

One page summary