Background Best practice standards recommend that specialist palliative care advice should be available, 24/7, to service users and healthcare partners, to achieve good end of life care. Currently, there is variable access to 24/7 specialist palliative care advice.

Aim Assess the feasibility of an integrated 24/7 telephone advice line across four hospices to improve equitable access to specialist palliative care and augment capacity through creative and efficient use of resources.

Methods Community service leads from four hospices met over a two-month period. Methodology included evidence gathering from current 24/7 telephone advice service provision and demand. Service models were interrogated against a feasibility framework, considering whether initiatives: could be progressed within current resources, were realistic given current service pressures, would result in efficiencies, increase specialist palliative care capacity across the system, had potential to alleviate pressures across the end of life care system out of hours and had enough enabling factors to give a good chance of success.

Results Within eight weeks, a shared ‘Hospice Line’ model, which defined and standardised the deliverable elements of 24/7 telephone advice and support, was developed. A phased approach was recommended to enable partner hospices to benefit from each pilot as a discrete, stand-alone initiative to add value and efficiency across their 24/7 telephone advice provision. Subject to proof of concept these could then be built upon to realise a fully integrated ‘Hospice Line’.

Conclusions Progressing clinical integration across hospices is challenging. This project introduces a sequential approach that enables partners to embark on integration ‘one step at a time’, mitigating risk, building trust and positive culture change with each progression.

How innovative or of interest is the abstract?With effective leadership, senior management commitment, the right stakeholders and a shared goal, proposals to support system-wide changes can be researched and developed at pace. This one step approach could be adopted for other integration initiatives.