Background and Methods Professionals in Liverpool have designed the IMPaCT (Integrated Mersey Palliative Care Team) model of care to improve access for patients, their families and other professionals. The COVID-19 pandemic enabled implementation of this much more quickly than envisaged. The IMPaCT service in North Liverpool was piloted over July to September 2020 and went ‘live’ in October. The ‘Hub’ accepts calls and referrals from anyone and comprises coordinators from hospice outpatient, hospital and community palliative care specialist nursing teams. This single point of access allows for sharing of information, elimination of duplication, and reduces delays in care. Patients are no longer discharged when they move between settings; once they are referred to the IMPaCT service, they remain on the locality caseload until their death.
Results In North Liverpool 136 patients have been regularly reviewed under the newly formed nurse-led surveillance clinic in place of the old medical outpatient system. Where medical input was required, advice could be sought from the hub doctor and patients could be seen in the new ambulatory clinic or at home as needed. Of 21 patients were referred for hospice inpatient admission, 18 were admitted within 1 day, an improvement on the 2019–2020 average time from referral to admission of 3 working days. Of 26 patients triaged for medical outpatient review 23 were reviewed within 24 hours (8 same day) â€’ the previous average was 15 working days from referral to appointment.
Conclusions The switch to a daily ambulatory clinic has improved timeliness of medical assessment and domiciliary visits have been completed in a more timely manner due to freeing up medical availability. Co-location of team members has enhanced information sharing and transfer of care between settings. Patients, carers and staff have reported the benefits of reduced waiting times for specialist input across the services.
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