Background Near the end-of-life people often experience ‘crisis’, resulting in emergency hospital admission. The way in which we care for our dying has changed; given the complexity of dying in older age and with co-morbidity (Bailey, Guo, MacArtney, et al. Frontiers Public Health. 2023;11: 1–17). Nationally hospices are innovating to manage palliative care crisis but there is a significant lack of evidence to demonstrate what is working and what is not. One hospice in the Midlands of England is providing end of life care to people expected to die within 14 days at risk of hospital admission. People can be admitted from the acute hospital or from community into Accelerated Hospital Discharge Beds (AHD) to avoid hospital admission at the end of life.

Methods Service evaluation of the AHD Beds identifying utilisation, types of admission, carer feedback about the impact on quality of life for the dying person (Canaway, Al-Janabi, Kinghorn, et al. Palliat Med. 2017; 31(1):53–62) and a staff survey from admitting sites and the hospice exploring challenges and benefits.

Findings Utilisation has increased throughout the duration of the project, particularly as issues with admission were resolved e.g. transfer of care documentation. Carer feedback demonstrates hospice beds had a significant impact on quality of life, particularly around communication, having dignity and support from 24/7 hospice care and family support.

Conclusion Innovations like the AHD beds are a beneficial model to reduce emergency hospital admissions, increase satisfaction with preferred place of care and quality of care received and can enable cost savings in comparison to hospital admission. More research needs to be done about hospice-based crisis interventions nationally to prevent hospital admissions.