Background There are increasing challenges to providing consultants in palliative medicine which are contributing to unit closures or reduction in beds. These include: deficit of more than 70 consultants nationally; part-time workforce on increase; fewer doctors becoming consultants; 30% of workforce are over 50 years old.

Aims To establish a solution to provide a unique remote-based consultant model with a robust governance system. This would ensure a rapid response, improved team dynamics and reopening of units or prevention of unit closure.

Methods Initial set up of service level agreement with a hospice that was threatening unit closure due to inability to recruit consultant establishment. Services included daytime support of board rounds and MDTs to inpatient units via videoconference, with a secure system to record management plans, outcomes of board rounds, clinical supervision sessions and case debriefs.

Senior consultants facilitated a remote clinician to clinician telephone consultation service 24 hours a day, 365 days per year to support services. Service reviews were carried out after a month, 3, 6 months, and annually to evaluate services and gather feedback from users.

Results Over 60 organisations have SLAs for our services leading to enhanced confidence and autonomy with clinical decision making and improved team dynamics. Reopening of units or prevention of unit closure. Partnering organisation benefits from the added assurance of governance team who review all advice, response times and feedback on any identified training needs.

Conclusion Although on site consultant is the preferred method, evaluation of the unique remote model feedback gathered shows hospices, NHS organisations and communities benefit from collaboration and partnership with this independent solution.