Background: Implementing evidence and transferring evidence from one context to another is a recognised challenge. Implementation science offers a theoretical framework to interpret features of context and mechanisms which support or inhibit the use of such evidence. 

 Aim: to describe the use of implementation science and the outcomes of using monthly ‘Palliative Care Needs Rounds,’ developed in Australia, to the UK context where specialist palliative care nurses provide care home staff with practice-based support and learning. 

 Methods: This was a pragmatic implementation study using the iPARIHS (integrated-Promoting Action on Research Implementation) framework. The aim was to determine what worked, for whom, and in what circumstances for the UK version of the Australian Palliative Care Needs Rounds model. We co-designed the UK model using four workshops and 52 qualitative interviews with care home and hospice staff. Implementation was in six sites across the UK. The study was conducted during national and local COVID-19 lockdowns in 2020-22. 

 Results: Twenty-nine care homes used Needs Rounds. The monthly discussions were valued by care homes, helping to build staff skills and confidence, and sometimes improved communication mechanisms with families and other professionals. Residents benefited from improved quality of dying. Relatives benefitted through improved communication. There was a lack of coherence in the early implementation phase, with mixed understanding about how Needs Rounds would function, though this changed over time. 

 Conclusion

Not all parts of Needs Rounds were successfully implemented across the sites. Contextual factors, including COVID-19 restrictions, impaired the success of implementation. Transferable lessons for implementation include attending to how primary care interact with care homes and the need for feedback loops between palliative care and care homes.