Background COVID-19 was declared a pandemic by the World Health Organisation on 12th March 2020. Whilst COVID-19’s general impact on health systems is well documented at a national and international level, is as yet unknown how individual hospice-based palliative care services have been affected.

Aims To assess how COVID-19 affected the palliative care service at Wirral Hospice St John’s (WHSJ).

Methods The first wave of COVID-19 cases in the UK initially peaked during March, April and May 2020. We collected data from the Hospice’s local data system comparing those months in 2020 with 2018 and 2019, as well as longitudinally from September 2018 until present. We looked at inpatient referrals, inpatient length of stay, time from admission to death, outpatient referrals, and outpatient deaths. Secondary outcomes investigated included referral sources to WHSJ outpatient services, and time waiting for a package of care, both measured longitudinally from January 2019 until present.

Results The most significant result found from this study revealed a 64% drop in average monthly outpatient referrals to the hospice during the 1st peak of the Coronavirus pandemic, dropping to 17.3 in March to May 2020, compared with 46 in the same monthly period in 2018 and 51.3 in 2019. This trend is even more apparent when viewed over a full two-year timeframe. Further to this, a sharp decline in the number of hospital referrals to outpatient services was seen, dropping from 19 in February to 5 in April 2020.

Discussion/Conclusions The main conclusion that can be drawn from this dataset is that COVID-19 pandemic likely reduced the rate of outpatient referrals to WHSJ. The sizeable reduction is likely multifactorial; due to patients shielding, a reduction in face-to-face GP reviews, reduced hospital admissions for non-COVID-related diseases, wellbeing services unavailability, and a perceived reduction in service capacity.