Background The NHS long term plan (NHS England. Available at: https://www.england.nhs.uk/publication/the-nhs-long-term-plan/ [Accessed 01/10/2023]) aspires to reduce avoidable emergency admissions and increase community care for people towards the end of life. Mountbatten Hampshire (MH) conducted a review to determine whether hospital admission of patients known to our service were appropriate.

Methods From a caseload of 864 patients, 259 were cross-referenced with hospital data to find the number admitted to hospital over 12 months. 247 cases were analysable. A retrospective notes review to determine appropriateness of hospital admission was undertaken by two reviewers (every 5th set of notes of admitted patients sampled (n=20); 2.3% total caseload, 8% of data analysed by hospital).

Results 45% (111) of analysable cross-referenced group were admitted to hospital (mean age 94 years, 45% male). Of patients sampled, 70% (14) were known to our service. All admissions were unplanned. MH was contacted in 4 cases prior to admission. In one case it was felt we could have prevented admission if the patient had been reviewed at home by our community rapid response team. Ten patients were admitted without immediate prior contact to our service by carer or health professional. On review, 3 of these admissions could potentially have been prevented if the patient had been assessed by our community rapid response team prior to being taken to hospital.

Conclusions More patients were known to our service at admission compared to a previous review (70% cf 33%). 71% (10/14 hospital admissions were appropriate; 29% (4) admissions could have been avoided. Had our team been contacted we could potentially have prevented 30% (3) admissions. There was a predominance of patients >90 years with non-malignant diagnoses. The findings suggest more work is required to alert patients, carers and health professionals to our 24-hour service to ensure people, particularly with non-malignant diagnoses, are cared for in the appropriate setting.