Introduction In April 2013 the Palliative Care Partnership, a collaboration between a NHS Community Palliative Care Team and a charitable Hospice at Home service was commissioned to provide community palliative/end of life care for patients in the local area.

Aims of service Improve outcomes for all patients locally with palliative/end of life care needs, regardless of diagnosis

Improve patient and carer experience

Maximise use of existing resources by reducing duplication and optimising efficiency: “right care, right time, right place”.

Methods More joined-up approach to care/support achieved by:

• Single point of access 24/7 via telephone hub, manned by NHS and hospice staff

• Joint triage system

• 7 day week visiting service

• Shared electronic patient record system

• Joint multidisciplinary meetings

• Joint governance framework

• Collaboration with other services.

Results Successes:

• Key Performance Indicators (KPIs) met/exceeded

• Reduction in inappropriate hospital admissions (>10/month, a saving of at least £200,000/annum to local health economy)

• Dying in Preferred Place of Care increased to 89%

• Telephone hub activity increased by over 50% out of hours

• 64% increase in first year in number of referrals with highly complex needs

• Carer feedback shows 83% received help as often as they needed

• Excellent feedback from local services

• Rating of “Outstanding” for responsiveness in Trust’s latest CQC inspection.

Challenges:

• Demand on telephone hub soon exceeded capacity. Given the cost effectiveness of the service and impact on outcomes, additional resource was awarded by the commissioners

• Merging two organisations with different cultures, funding arrangements and systems. The common goal of high quality patient-centred care helped to overcome these challenges

• Data collection has been time consuming. We are currently refining our processes.

Conclusions Partnership working can significantly benefit patients and carers and be cost effective. KPIs need to be reviewed regularly to drive further improvement. Data collection and audit are key for service development.