Background Key to Mountbatten’s strategy is to support people at end-of-life in their preferred place of care. For those for whom their preferred place of care is home, complex symptom management is well supported by the Mountbatten Community Team of Clinical Nurse Specialists, Doctors and Consultants. However, it was identified that some individuals were being admitted to the hospice in-patient unit due to functional deterioration associated with symptoms, that was compromising the safety, wellbeing and dignity of the individual and/or those caring for them, leading to a crisis situation that demanded an admission. Timely intervention to address such functional changes and avoid crisis was limited, as the Mountbatten Community Team accessed community Occupational Therapy assessment via NHS commissioned services which were not consistently able to respond urgently, and do not have palliative care specialist clinicians.

Aim(s) To develop a hospice responsive, flexible, specialist palliative rehabilitation service to support individuals in the community when complex symptoms impact on functional abilities and threaten an unwanted crisis hospice admission. To avoid crisis admission with appropriate functional assessment, intervention and equipment provision.

Method A Hospice Admission Avoidance Service (HAAS) was piloted for five months, aimed at exploring whether an in-house, specialist hospice rehabilitation service could provide timely, proactive interventions to enable an individual to remain at home by addressing changes in functional needs as a result of complex symptoms. A proposal was written and agreed, and a referral process was developed and communicated with the Mountbatten Hospice Teams who would be making referrals.

Results The data from the five-month pilot, including number of referrals, reason for referral, responsiveness, and outcome will be collated, illustrated and shared to provide an evaluation of the service and guide any actions or recommendations that may be indicated.

Conclusion This development will ensure Mountbatten’s strategy to support people at end of life in their preferred place of care is realised.