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This study found that hospice at home services overall provided care likely to deliver 'a good death' and identified features of different models that deliver best patient outcomes.

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Claire Butler 1,*, Patricia Wilson 1, Vanessa Abrahamson 1, Rasa Mikelyte 1, Heather Gage 2, Peter Williams 3, Charlotte Brigden 1,4, Brooke Swash 5, Melanie Rees-Roberts 1, Graham Silsbury 6, Mary Goodwin 6, Kay Greene 7,8, Bee Wee 9, Stephen Barclay 5

1 Centre for Health Services Studies, University of Kent, Canterbury, UK
2 School of Biosciences and Medicine, University of Surrey, Guildford, UK
3 School of Mathematics, University of Surrey, Guildford, UK
4 Pilgrims Hospices, Canterbury, UK
5 School of Clinical Medicine, University of Cambridge, Cambridge, UK
6 Lay author (member of the public), University of Kent, Canterbury, UK
7 Mary Ann Evans Hospice, Nuneaton, UK
8 National Association for Hospice at Home, Fareham, UK
9 NHS England, London, UK
* Corresponding author Email: c.butler-779@kent.ac.uk

Declared competing interests of authors: Vanessa Abrahamson has declared employment as a research associate at the University of Kent for the duration of this project and has received funding from the OPtimum hospice at home services for End of Life care (OPEL) project to attend and present OPEL findings at the (online) 2021 International Conference for Realist Research, Evaluation and Synthesis (February 2021). Charlotte Brigden has declared facilitating a support group for clinicians and academics involved in palliative care research projects (the Kent and Medway Palliative Care Research Group). Brooke Swash has declared research funding for other projects from Macmillan Cancer Support (London, UK) and Marie Curie (London, UK) and additional employment as senior lecturer at the University of Chester. Bee Wee has declared that her employer (Oxford University Hospitals NHS Foundation Trust) is reimbursed for her time as National Clinical Director for End of Life Care, NHS England and NHS Improvement.

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