Background Non-malignant diseases have advocated for the involvement of palliative care services to help deliver end-of-life care for patients and carers. The challenge comes within a fiscally constrained health economy when the drive is to cut and ultimately balance budgets. Therefore palliative care needs to be clear with its stakeholders in articulating the needs of the populations it serves and how it will deliver care in tandem with existing services across the multiple settings of care.

Aim To articulate a service specification in terms of care delivery for non-malignant disease couched within the wider remit of the health economy commissioning groups.

Method An iterative process of baseline review, literature review, horizon scanning with other providers and involvement of specialist and generalist teams.

Results A working group with professionals tasked internally with delivering care within non-malignant diseases was convened, with an action plan using a solution focused approach guiding the process. Each nominated person was responsible for devising a model of care that would ensure effective care delivery embedded within an environment of structured holistic assessment ensuring consistency, clarity and uniformity. This approach was guided by aligned work from the sustainability and transformation plans (STPs) within the external Clinical Commissioning Groups (CCGs). Discussion with external stakeholders and testing of proposed approaches was proposed to ensure suitability, feasibility and piloting of any new practice will deliver in terms of patient and carer experience and cost effectiveness.

Conclusions The piece of work is visually represented to ensure that a model of care can be clearly articulated to all stakeholders be they internal or external. This helps funding in terms of our charitable donations as patrons know what we do and for external commissioners with what we do that is different to other providers. Ongoing evaluation in terms of patient experience and cost effectiveness is pivotal.