{
  "abstract": "Background People experiencing homelessness experience severe health inequalities and often die at young ages (Public Health England. Health matters: rough sleeping. 2020 [internet]; Shulman, Hudson, Low, et al. Palliat Med. 2018;32(1):36–45). Despite high and complex needs, barriers limit access to palliative and end-of-life care (Shulman, Hudson, Low, et al. Palliat Med. 2018;32(1):36–45).Aim In an area where the mortality rate of people experiencing homelessness is higher than the national average, a hospice wished to address the needs of people experiencing homelessness in palliative and end-of-life care.Method Coproduction involves the target audience in the conceptualisation, delivery and evaluation of services (Filipe, Renedo, Marston. PLoS Biol. 2017;15(5):e2001403). A Volunteer Community Lead from a lived experience forum has been a project member for two years. They have co-produced focus groups; co-designed and implemented an outreach project; and co-facilitated events and a community of practice.Results Long-term involvement from the Volunteer Community Lead supported the project in:Increasing interest and understanding of palliative and end-of-life care in people experiencing homelessness.Accessing service organisations and individuals within the homelessness community.Building trust for the project.Ensuring accessibility of materials.Adding a lived experience perspective and aiding professional understanding of structural vulnerabilities.Addressing ethical issues.Benefits realised by the Volunteer Community Lead included gaining a better understanding of the health system, greater comfort around presenting and facilitating project material, and experience working as a partner within a multidisciplinary team.We faced several challenges to this kind of long-term evolving Volunteer Community Lead role, including tension around appropriate compensation, ensuring the Volunteer Community Lead had true power and voice, and that there was appropriate scaffolding to support their role. We also reflect on the weight of one person representing a varied group, the emotional strain of involvement, and evolving positionality as an ‘outsider’ over the project.Conclusion Co-production of palliative and end-of-life care research and services with people experiencing homelessness is critical but must be done thoughtfully. The TIFFIN recommendations provide needed best practices (Crooks, Flemming, Shulman, et al. Palliat Med. 2024;38(7):746-754). Our experience with the Volunteer Community Lead has implications for projects seeking sustained involvement of those with lived experience.Funding and support for the project was received from St. James’s Place Charitable Foundation (via a grant managed by Hospice UK) and Sobell House Hospice Charity.",
  "authors": [
    {
      "affiliations": [
        "Oxford University Hospitals NHS Foundation Trust, Oxford, UK"
      ],
      "name": "Nicole Satullo"
    },
    {
      "affiliations": [
        "Lived Experience Advisory Forum, Oxford, UK"
      ],
      "name": "Maria Hart"
    },
    {
      "affiliations": [
        "Oxford University Hospitals NHS Foundation Trust, Oxford, UK"
      ],
      "name": "Lynn Erskine"
    },
    {
      "affiliations": [
        "Oxford University Hospitals NHS Foundation Trust, Oxford, UK"
      ],
      "name": "Mary Walding"
    },
    {
      "affiliations": [
        "Oxford University Hospitals NHS Foundation Trust, Oxford, UK",
        "Nuffield Department of Medicine (NDM), University of Oxford, Oxford, UK",
        "Harris Manchester College, Oxford, UK"
      ],
      "name": "Bee Wee"
    }
  ],
  "title": "P-167 Reflections on lived experience co-production of a palliative care homelessness outreach project: needs assessment and project design, implementation and evaluation",
  "uid": "bfd47f34-9d0f-52e2-849d-81fb7c97f90a"
}