Background In April 2019, Fife Community Nursing and Unscheduled Care Services established the District Nursing Palliative Care Helpline. This new model of urgent community palliative care aimed to provide people in Fife, Scotland, in their last weeks of life with direct access out of hours to district nursing support without the need to go through NHS 24. At the start of the COVID-19 pandemic, the helpline was extended to run 24/7. This study aimed to evaluate the usage and impact of the helpline in its first three years.

Methods A retrospective evaluation was undertaken, examining service data from the helpline’s launch in April 2019 up to March 2022 and linking it with other regional health service datasets. In parallel, an electronic survey was distributed to all district nurses in Fife to explore their views on the helpline’s impact.

Results In the three years since its launch, the helpline has received 10,439 calls, relating to care for 2,393 people. Calls are received 24/7, from all areas of Fife and equitably across all categories of socioeconomic deprivation. Calls are most commonly triggered by uncontrolled symptoms. 84% of helpline users die in their usual place of residence. 36 District Nurses completed the survey. 89% (32/36) reported that patients had been receiving ‘better’ or ‘much better’ care since the helpline’s introduction. 64% (23/36) stated that they were now in a ‘better’ or ‘much better’ position to deliver care in the community, with only 6% (2/36) indicating a worse situation.

Conclusion District Nurses are core providers of planned and urgent palliative care in the community. This innovative helpline enables more people in Fife to access timely and responsive palliative care in their homes in their last weeks of life. Further evaluation is now needed to assess the impact on district nursing workload and future sustainability.