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P-39 A 10 year retrospective of a single point of access
  1. Nicky Coombes
  1. St Helena Hospice, Colchester, UK


Background Palliative and end-of-life care (PEOLC) should be coordinated (Ambitions for Palliative and End of Life Care, 2021) and include access to out-of-hours care (NHS England. Palliative and end of life care: Statutory guidance for integrated care boards. 2022). It is recommended that high-quality out-of-hours community services need to be prioritised as deaths are predicted to increase (All-Party Parliamentary Group Hospice and End of Life Care, 2023). The SinglePoint of access was launched in 2013. The 10-year anniversary offers an opportunity to reflect on the challenges and successes of the last decade.

Aim To develop a telephone triage service for people in the last year of life in North East Essex, including a rapid response visiting service for people in the last year of life.

Method Beginning as a 12-hour service, it was quickly expanded to 24/7. In 2020, due to the first wave of the COVID-19 pandemic, it expanded into a PEOLC hub, coordinating discharges from hospital, fast track continuing health care, and referrals to the community nurse palliative care team, the hospice rehabilitation team and the virtual ward service for people in the last weeks of life. In 2022 the team was expanded by four rotational paramedic roles in collaboration with the local ambulance trust. Its work is supported by a well-embedded Electronic Palliative Care Coordination System.

Results In 2022/23 the service included 32 full time equivalent roles, including call handlers, senior nurses, non-medical prescribers, night time health care assistants, occupational therapy, physiotherapy, and a therapy assistant, in addition to the four new rotational paramedic roles. Last year SinglePoint of access received 45,554 calls relating to 2553 people and delivered 1103 rapid response visits. The average wait for a visit was 91 minutes. Service audits show high achievement of preferred place of care and patient feedback is positive.

Conclusion Hospices can deliver integrated 24-hour PEOLC services to support care coordination for people across the community.

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