Background Recognition of dying is important to give people time to communicate and achieve wishes, organise finances and begin the bereavement process. This audit aims to evaluate the time between recognition of dying (ROD) and death among inpatients at a District General Hospital and the impact of involvement of the Specialist Palliative Care Team (SPCT).

Method A two-cycle audit was completed. Cycle 1 reviewed 49 decedents from April-May 2020; Cycle 2 reviewed 21 decedents from October 2020. Data included length of admission, involvement of SPCT, date treating team ROD and date SPCT ROD. Standards were based on National Audit for Care at the End of Life data. Interventions included education and attendance at board rounds.

Results National standards were met in many areas. Data was significantly above standards with SPCT involvement. 88% (43/49) of decedents were recognised as dying. Median time between recognition and death: 48 hours with 81% (35/43) of people dying more than 24 hours after ROD. This is an improvement on the national standard of 88%, 41 hours and 64% respectively. Cycle two showed 33% (7/21) seen by SPCT with 71% (5/7) of these recognised as dying. Median time before death: 52 hours, with 80% (4/5) dying more than 24 hours after ROD.

Conclusion Results indicate SPCT involvement extends time between ROD and death. Perhaps due to experience in caring for dying people, having more in-depth discussions potentially revealing information to guide prognosis and the characteristics of persons referred to them. This has supported increased referrals to the SPCT and led to further work considering earlier opportunities to involve the SPCT in a person’s care.