Background Thorpe Hall Hospice is commissioned by the Integrated Care Board (ICB). For two years, Thorpe Hall Hospice was only able to open half of their beds, due to only having one medical consultant in post. The ICB approached Thorpe Hall Hospice to enquire how they could use the non-occupied beds to support patients who were medically fit for discharge but required palliative and end of life care. Patients were dying in hospital which was not their PPoD. In 2022 more than 13,000 beds in acute services were occupied by patients who were medically fit for discharge, this has since increased over the last two years by 57% (The Health Foundation. Why are delayed discharges from hospital increasing? Seeing the bigger picture. 2023).

Aim The aim of this initiative is to ease the pressures within the local integrated care system. Following a local audit, it was also recognised that patients who had a PPoD for hospice were dying on our waiting list. Thorpe Hall Hospice recognises the Choice in End-of-Life Care Programme Board (2015) that supporting and working with communities can help to achieve the best outcome for palliative and end of life care patients (The Choice in End of Life Care Programme Board. What’s important to me: A review of choice in end of life care. 2015).

Method From research and learnings of other hospices with nurse-led beds, and evaluation of the positive benefits, Thorpe Hall Hospice explored the opportunity of this initiative. We made the decision to implement a model of a medically light concept. A range of quality and governance processes were developed and implemented to give a clear understanding of referral criteria, roles and responsibilities, and engagement and communication with the local acute Trusts and community services. A nurse completed the V300 qualification.

Result Thorpe Hall Hospice was to be funded initially for one year. Medically light referrals and admissions have increased. Fewer patients are dying in the local hospital and on our waiting list. Staff have gained skills and increased confidence, autonomy, and job satisfaction.

Conclusion Funding continues.