A large proportion of people spend their final year of life at home, with many expressing a preference to die there. However, this often requires access to care beyond normal working hours. Out-of-hours palliative services, typically delivered by multidisciplinary teams that include Health Care Assistants (HCAs), play a vital role in supporting patients and families. Despite this, there is limited understanding of how HCAs contribute to these services and influence patient care. This study aims to explore and clarify the role, input, and impact of HCAs in out-of-hours community palliative care provided by hospice organisations. This exploratory investigation adopts a mixed methods design comprising four interconnected stages. Stage one will conduct a scoping review to chart existing evidence and policy related to the HCA role in out-of-hours palliative care and to identify areas of limited knowledge. Stage two involves a UK-wide online census of hospices to describe variations in service models and define the nature of HCA involvement. Stage three will undertake multiple organisational case studies across representative service types, gathering both qualitative and quantitative data from HCAs, patients, carers, and service managers to understand practice and experiences in context. Stage four will integrate and refine the findings through a series of online focus groups. Ethical approval for phase two has been granted by the Ulster University Research Governance Filter Committee (Nursing and Health Research). The study’s findings will be shared through academic publications, conference presentations, and professional networks, including social media channels.
