Background Persons experiencing homelessness face inequalities in accessing palliative care. Saint Francis Hospice in Havering had supported only three such patients in three years and had weak links with external organisations supporting this vulnerable population. This project aims to enable better access by those experiencing homelessness and their care providers in three London boroughs.

Method Apply for charitable funding to: promote our project at a stakeholder event, develop relationships between our hospice and external organisations, host a virtual educational programme for internal and external staff and develop a hospice homelessness referral pathway and guideline.

Results Our hospice successfully gained charitable funding for this 18-month project, which commenced in January 2021. A homelessness referral pathway and guideline were developed for use by hospice staff. The project was promoted to forty stakeholders at the launch event and the first education programme successfully provided 12 hours of teaching. An experienced palliative care nurse dedicates one day a week to the project and has successfully built relationships between our hospice and two hostels, one supported living service, three local authorities, two religious organisations, four community healthcare teams, one hospital team and two homelessness charities. These are now better aware of when and how to make referrals. This work has yielded one referral, four patient encounters and seven advice encounters.

Conclusion Good groundwork has been achieved through developing hospice guidelines, an education programme, and the cultivation of links and advice encounters with external organisations supporting persons experiencing homelessness. Lower than anticipated referral rates demonstrate the extraordinary challenge in tackling the inequalities in access faced by this population and highlights the need to take this service further into the community. This solid start provides the foundation necessary to promote referrals going forward and future work includes hospice nurse drop-ins at hostels and an ongoing education programme.