Background St Christopher’s Hospice provided a community palliative care service to 7,500 patients in 2022–2023 (St Christopher’s. Quality account: 2022–2023). During which time a local Clinical Commissioning Group aligned with Primary Care Networks, bringing new challenges to the concept of continuity. To address this, St Christopher’s transitioned from team-based working across large boroughs, to smaller ‘network caseloads’ in March 2023.

Aim This service development initiative was to see whether patient experiences and outcomes improved.

Method A retrospective review of clinical notes, patient and carer feedback and staff surveys were undertaken and compared to data pre-network caseload working. Data was captured to evaluate results using three of The Lantern Model patient outcomes; safety, knowledge, and opportunity to care (https://www.stchristophers.org.uk/lanternmodel).

Results Work in progress, to be presented via charts. Initial results for safety have demonstrated improved continuity and reduction of time spent with unmanaged urgent palliative care needs. So far results for knowledge have demonstrated an improvement in a sense of control and understanding about the current and future health situation.

Conclusions so far Network caseload working is now well embedded at St Christopher’s. Quantitative results thus far have shown an improvement in continuity of care; a maximum of two clinicians involved in care (65% to 80%). The time a person spends in an unstable phase of illness has reduced with urgent needs being met within 1 day (50% to 85%). Historical feedback has demonstrated a ‘lack of knowledge and control’ which recent feedback has shown to be improved, with all patients and carers having no hesitation in asking their named nurse for further information. Further interviews and staff survey results will be analysed this summer to assess for service users’ perceptions in opportunities to care.