Hospice chief executive officers serving the Lancashire & South Cumbria (L&SC) ICS area began to meet weekly at noon each Thursday, initially, as a response to the pandemic. Throughout the year, as trust and partnership working grew, a number of successes and initiatives emerged. The main one being an excellent relationship within our newly developing ICS.

During the initial stages of the COVID-19 pandemic a marked increase in demand for community end-of-life care was experienced within L&SC. After a presentation to the ICS by the 8 adult hospices, a discussion took place regarding the critical partnership role the hospice sector had played in enabling the system to respond to the changing preferences of the population during that period.

ICS Board members noted the potential opportunity this presented to increase joint working between the hospice sector and Out of Hospital services during the Winter period to support system resilience. After further discussion with the ICS, the opportunity was identified to undertake a rapid pilot scheme to demonstrate how a small amount of additional funding (£200k) provided at system level could increase the retention of vulnerable end-of-life patients in the community during the Winter period as part of the system COVID-19 management approach.

Models of care were not specifically prescribed, hospices’ ICP commissioning arrangements meant that there were different starting points and local requirements, but it was agreed that measures of success might be:

• Number of patients supported and the number of interventions offered.

• Patients managed in preferred place of care.

• Number of hospital admissions and primary care interventions avoided.

Hospices also agreed to provide compelling patient stories to ‘bring to life’ the power of the work they could do as ‘community anchor’ organisations to support the wider system and to reduce health inequalities. Pilots were diverse and successful, many have now become part of core services.