Introduction The End of Life Care (EoLC) Strategy (2008) and Preferred Priorities of Care (2011) documents support enabling people to remain in their own homes.

Prompted by the volume of calls into the in-patient unit, and workload of the district nurses in the early evening, the hospice piloted an extension to the Hospice@Home (H@H) working hours.

Aim To reduce unnecessary admission to hospital at the end of life by providing extended access to support and guidance for patients, carers and health care professionals.

Method Following a three month analysis of telephone advice calls received by the Inpatient Unit (IPU), outside of H@H working hours, the pilot took place over a 9 month period. This extended the accessibility of trained nurse contact from 4.30pm to 9pm on a daily basis.

Results Throughout the pilot phase, calls were recorded and outcomes summarised, paying particular attention to the purpose of calls, caller identity, and the time the call was received. These statistics provided evidence that the service was not routinely accessed after 7pm.

During the pilot, five admissions to hospital were prevented, primarily due to the swift response and symptom management by H@H. Patients and carers benefitted from the flexibility and accessibility of a trained nurse to action changes, provide continuity and reassessment from 8.30am until 9pm.

There were a high proportion of calls requesting complex symptom advice, reporting family distress and requesting an increase in care.

Conclusion Staffing the extension to the service proved challenging however the pilot was positively evaluated by the district nursing team.

Guidance, reassurance and prompt response to need, undoubtedly contributed to the prevention of crisis admissions to the acute trust.