Background The historic fast-track process involved paperwork being sent directly to the Commissioning Support Unit (CSU) for processing. Hospice-at-Home were not aware of which patients had been fast-tracked with a tendency to refer to the service at point of crisis.

Aim Develop a Hospice-at-Home Single Point of Access (SPOA) for fast-track administration. Timely sourcing of care packages, streamlining administration and avoiding unnecessary delays. Hospice-at-Home would be aware of all fast-tracked patients who would access services earlier in their journey, preventing crisis situations and supporting advance care planning. A pilot group of domiciliary care providers worked collaboratively with the SPOA to provide night sit packages, whilst day care packages were forwarded to CHC/CSU.

Method A fast-track template was designed and available within the shared record. Once completed, the SPOA would be informed, template reviewed and notified domiciliary care providers would respond within two hours if they could accept the patient. If no response, the application was forwarded to the CSU. The template was accepted as a referral into Hospice-at-Home, ensuring patients accessed timely palliative care.

Results The SPOA processed 495 Fast-track applications (342 patients) between 01-May-2021 and 31-March-2022.

Nights: 106 applications

Days: 245 applications

Days/Nights: 116 applications

Other: 28 applications (Nursing Homes, change of provider)

86.5% Night sit applications: sourced from Hospice-at-Home/Domiciliary care providers within two hours.

33.5% increase in Hospice-at-Home patient contacts.

8% increase in Hospice-at-Home caseload.

Conclusion The project demonstrated 86.5% night sit fast-tracks were processed within two hours and increased the Hospice-at-Home caseload. The SPOA aligned to the palliative care ambitions document (National Palliative and End of Life Care Partnership, 2021): each person getting fair access to care and care is coordinated. EMIS shared-record minimised duplication with one template for referral and fast-track application. Domiciliary care received the fast-track application, reporting this information was invaluable, supporting coordinated care.

Innovation EMIS shared-records minimised duplication, maximising information sharing. Several organisations worked collaboratively to support patients receiving care in a timely manner.