Background A South West London Hospice receiving around 900 referrals per year.

First Point of Contact (FPC) service was established following identification of variation in response times for initial contact to arrange assessment.

In collaboration, a Triage service provides immediate access to a Clinical Nurse Specialist (CNS) for advice, support and responsive emergency visits.

Aims To provide an efficient, responsive referral service.

To provide accessible telephone support for patients, relatives and professionals

Provision of a responsive approach to requests for urgent home visits.

Service configuration A team of three CNSs (WTE 2.2) covering 08:30-18:00 Monday-Friday.

Referrals reviewed on receipt with responsive contact

Urgent referrals initiate immediate FPC contact to assess and where necessary a same day visit by the triage CNS.

Routine referrals assessed by telephone within 48 hours with first visit arranged within two weeks

FPC attends weekly Palliative Care MDT meetings at both local hospitals

The triage CNS offers telephone ‘help line’ advice and support to referred service users and professionals.

Outcomes Three month pilot (17^th December - 17^th March 2013) compared to November 2012 demonstrated:

• 70% improvement in response times to all referrals being contacted within 24hrs

• 94% of urgent referrals contacted within 24 hours

• 21% improvement in 2 week first visit

• 76% of received calls completed by Triage CNS supporting the community team.

• A result of service questionnaire from relevant stakeholders is awaited.

Implication to delivery of specialist palliative care

• Better end of life management within the community through advice given to GPs at point of referral e.g. ensuring appropriate documentation and medications in place

• Improved access to the hospice for referrals and advice

• Improved response to referrals

• Improved communication, collaborative working and outcomes for patients.