Background The evidence for acupuncture to address a range of symptoms in palliative care is emerging. Palliative care patients are increasingly interested in non-pharmacological therapies for challenging symptoms associated with disease or/and treatment (Birch, Bovey, Alraek, et al. J Altern Complement Med. 2020;26(9):784–791).

Aim To evaluate the direct and indirect outcomes of implementing a new nurse-led acupuncture service.

Method Dedicated weekly Hospice Outpatient Assessment (OPA) and fortnightly Outreach OPA and ad hoc Inpatient Unit input. Demand/activity data collection methods utilised SystmOne and Patient Outcome measures.

Results 106 patients received between one and four acupuncture sessions per course - total 201 acupuncture treatments over 12 months. 78% patients OPA setting, 22% IPU.

Wide spectrum of rationale for referral:

• Complex physical symptom and associated anxiety not responding to conventional intervention.

• Hot flare/flush.

• Chemotherapy induced peripheral neuropathy.

Patient outcome measures – Modified My Views on Care:

• 60% report at least some benefit in relation to expectation of acupuncture.

• 28% report a lot of benefit.

• 92% recommend acupuncture for someone with similar needs.

Additional benefits observed/reported:

• Patients value synergy/combined approach with pharmacological intervention.

• Symptom experience improved (a lot of benefit) – more apparent if underlying anxiety component.

Unanticipated benefits observed/reported:

• Patients value therapeutic touch in aiding a positive relationship between themselves and hospice.

• Patients/carers demonstrate greater insight into the breadth of hospice services.

• Majority of patients eager to engage in advance care planning discussions when prompted during acupuncture.

Conclusion Future hospice clinical service models could harness the potential role of the acupuncture service by:

• Routinely considering a parallel role with hospice pharmacological expertise to address challenging symptoms which have a recognised anxiety component.

• Using acupuncture as a segue to explore and promote advance care planning.