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We wanted to build on the 2022 analysis of comorbid adults who died in hospital, which found that 18% had been over-treated and 23% had not had medications stopped as patients deteriorated.1 We wanted to see if local data reflected recognising palliative care (PC) needs and reducing medically overburdening patients. The PC hospital teams at University Hospitals Sussex see over 2000 referrals a year and over 1000 deaths under their care. Alongside this, there are numerous factors that impact timely referral and subsequent care before death in hospital or before a successful discharge, which are beyond our control.