Introduction Increasing referral numbers within a rural location have prompted us to explore new ways of working to not only increase timely access to specialist palliative care services but also to also ensure that these services, when deployed, function effectively and meet the changing needs of patients and families.

A Specialist Palliative Care nurse led satellite clinic based within a rural general practice offers scheduled appointments to appropriate patients,

• ▶ Facilitating enhanced communication with primary healthcare colleagues

• ▶ Expediating effective symptom control by facilitating multidisciplinary team working

• ▶ Promoting continuity and seamless care.

The project is important because it challenges traditional ways of working and standard community nurse specialist role.

Aims

1. To increase access to specialist palliative care services within a rural location

2. To expediate symptom control

3. To evaluate the patients experience of new models of service provision- this will inform future service development.

Methods

• ▶ A literature review was undertaken

• ▶ A potential pilot site and CNS caseload was identified

• ▶ Service user consultation was undertaken by one to one discussions

• ▶ Comparable services were benchmarked

• ▶ An audit strategy including a service user satisfaction survey, 360 degree review and use of recognised outcome measurement tools has been planned

• ▶ Key stakeholder support was secured and a pilot agreed.

Results Interim data suggests:

• ▶ Initial service user reluctance

• ▶ Improved team working with primary healthcare colleagues

• ▶ Increased user choice

• ▶ Reduced travelling time for CNS.

Discussion

• ▶ The satellite clinic is now established within a supportive GP practice

• ▶ A small number of patients are currently accessing the clinic

• ▶ Multidisciplinary team working with primary healthcare colleagues has been markedly enhanced

• ▶ The CNS's educational activity within the host practice is increased.