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O-9 Creating equity of community palliative care in manchester in a pandemic. does the ‘midhurst model’ of care work?
  1. Catriona Barrett-Ayres,
  2. Lindy Brooks,
  3. Sue Ware and
  4. Sharon Royle
  1. Manchester Local Care Organisation and Manchester Heath and Care Commissioning


Manchester is among the most socially deprived areas in the UK leading to increased comorbidities, hospital attendances, admissions and deaths.1 Deaths will increase to the levels seen in the pandemic by 20402 3 with 75–90% benefitting from palliative care4 5 and many more home deaths expected.6 In 2015, North Manchester successfully piloted the ‘Midhurst Model’ of community palliative care.7 8 In 2018 this was extended citywide with extra funding from Macmillan, co-produced with service users.9

Method A service evaluation using qualitative and quantitative data in order to see if the model was successful and met the original aims and objectives.

Results Aims and objectives were mainly achieved. Patients, carers and community staff valued the regular support, 7-day service, single point of access and rapid access to support by appropriate staff. Patients/carers felt supported, respected and listened to, with less need to call other services. GPs and external staff rated the care highly. More time is needed to embed the service for district nurses. A reduction in bed days and preventable admissions was shown, with 90% of admissions deemed appropriate. More patients on the caseload were able to die at home with 89% achieving their preferred place of death. Timely identification of patients, discharge from hospital and advance care planning was promoted. Numbers on the caseloads and contacts increased exponentially. Remote reviews helped protect vulnerable patients. Work with ‘hard to reach’ (e.g. homeless) groups was undertaken. Patients were given bisphosphonates at home for malignant hypercalcaemia. Gaps identified were spiritual and level three psychological support and over representation of cancer and ‘white British’ patients on caseloads.

Conclusion The model of care worked well despite the effects of the pandemic. Financial savings are likely. Investment in community care is required going forwards.


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  10. National Palliative and End of Life Care Partnership. 2015. Ambitions for Palliative and End of Life Care: A national framework for local action 2015–2020 and 2021–2026. Available at: (Accessed Aug 10th 2021).

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