Background It was identified that when community nurses were called out to palliative care patients, particularly on evenings and weekends they felt that communication regarding the status of the patient could be improved. It was acknowledged that a quick reference register of all palliative care patients would be useful to enhance continuity and bring nurses up to date quickly and efficiently.

Aims The initiative was important in order that patients were empowered to remain in their preferred place of care, plan for the future and be able to make informed decisions about where and how they wanted to be cared for.

Method Patients preferred place of care was documented and actual place of care and death was monitored by the Macmillan clinical nurses specialist and via the Gold standards register to identify if patients were being cared for in a place of their choice and to ensure unnecessary hospital admissions were avoided. Feedback was also monitored from the community nurses and a confidence survey was carried out retrospectively to see if community nurses skills and awareness had improved. Changes included incorporating the Macmillan Clinical Nurse Specialist into a weekly designated ‘slot’ within the community nurse meetings. At this time the Macmillan CNS: Hands over the current status of those patients on the caseload Discusses any new referrals Informs staff regarding plan of care for particular patients and potential risk factors for the patient such as those at risk of spinal cord compression, poor renal function and risk of hypercalcaemia Discusses any queries or concerns that the community nurse may have.

Conclusion A confidence survey indicated that the community nurses were more aware of PPC and ACP. It also indicated and increased palliative care knowledge base.