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P-126 Development of a palliative advice and coordination centre

bmjspcare · 2025-11-21 · canonical JSON source

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Background Uncoordinated, fragmented care is a source of frustration and anxiety in the dying (National Palliative and End of Life Care Partnership. Ambitions for palliative and end of life care: a national framework for local action 2021-2026. 2021). Palliative and end of life services with availability 24/7 are key to building a system of high-quality care (National Institute for Health and Care Excellence. End of life care for adults. [QS13] Updated 2021 Sept. [internet]). In recognition of the existing gaps in palliative services, and in alignment with the Ambitions for Palliative and End of Life Care framework, the hospice embarked on a project to improve access and coordination of care.Aim Through the creation of a 7-day Palliative Advice Centre, the hospice is undertaking a 12-month ‘test and learn’ period, aiming to coordinate care and prevent crisis for people with life-limiting illness at any stage of their disease.Method In 2022, £15k was secured from Hospice UK/NHS England to scope the development of a single point of contact. Working in collaboration with the wider palliative care team, a joint referral form was developed. A dynamic digital whiteboard to share patients’ phase of illness (Hull York Medical School. Outcome Measures in Palliative Care. 2019 [internet]) has supported the introduction of informative daily huddles. Using designated hospice funding, additional senior nurses and a clinical coordinator have been recruited to facilitate an enhanced 24/7 advice line. Dedicated office space centralises calls, with time allocated to provide an immediate, expert response.Results In the first three months of the service, call numbers tripled (129 total calls), 24 home visits were undertaken and at least 14 hospital admissions were prevented. Huddles have improved collaboration with the wider palliative team, enabled seamless care coordination and facilitated timely reviews of unstable patients by the most appropriate clinician.Conclusions/next steps Active engagement in Gold Standard Framework meetings, collaboration with nursing homes and rapid discharge teams will support the pro-active endeavours of the service and reach people earlier. Coordination of care and crisis avoidance remain key priorities, with the ability to prescribe anticipatory medications for community patients coming soon.