Background Day hospices, along with most other healthcare services changed dramatically in response to the COVID-19 pandemic, this included halting face-to-face services, stopping traditional day hospice models and in this case being left wondering what their role within the provision of specialist palliative care was. There was a period of grieving for what was seen as the loss of the day hospice service by staff members, colleagues, patients and their families. Despite the challenges, there have been some very positive outcomes from these enforced changes.

Aim The discontinuation of face-to-face contact within a traditional day hospice model enabled teams to evaluate their roles and services, leaving a blank canvas to allow development of more accessible and responsive services to meet changing needs during and after COVID-19.

Method The break in service allowed time for obtaining feedback from all users of the day hospice including patients, carers and professionals, enabling the development of user-led systems, processes and services.

Development and growth Feedback enabled the team to develop pilot programmes aimed to help meet the needs of service users. The pilots were then tested using the PDSA cycle, ensuring robust evaluation processes were embedded within each.

Results Pilots included the development of virtual services, a community hub, and MDT outpatient suite. These pilots are currently being evaluated and results pending.

Outcomes

• The opportunity to reflect and re-evaluate service aims.

• A flexible, empowered, and confident team.

• Developing an accessible, user-led specialist palliative care service using a quality improvement approach.

• Robust evaluations in place to measure the impact of pilot services.