Palliative and end-of-life care services across Liverpool and South Sefton have been transformed over the last year to ensure that patients and their families have access to the right care from the right people when needed via a single phone number.

Patients and their families struggled to navigate previously complex health care systems in Liverpool. There were many different teams providing care across the hospitals, hospices, and community, usually requiring a referral for each new encounter resulting in duplication of work, multiple handoffs between services, and confusion amongst referrers. This meant that there was inequity in the level of service patients received and some patients were unable to get the care they needed.

The IMPaCT (Integrated Mersey Palliative Care Team) model is a consultant-led service to support patients nearing the end-of-life which was developed by reorganising existing services with key stakeholder involvement in the design. The essence of its success is collaborative working between services to prevent crises and timely response to problems as they arise. There are regular multidisciplinary meetings to ensure that services are directed to the areas of most need and ensuring that patients do not ‘slip through the net,’ especially on discharge from hospital.

There were 1320 patients supported by IMPaCT in April 2021. Referrals and calls for help come from any healthcare professional or patients and families themselves. Each call or referral is handled by a nurse specialist from the hospital, hospice or community specialist palliative care teams based in one of the two hospice hubs who assesses the patient’s needs and arranges intervention by the most appropriate person, removing the need for the patient to contact multiple agencies and reducing stress. The patient stays on the IMPaCT register unless they die, move away, or their illness is cured.