Background REACT launched in June 2022 as a three-year pilot delivered in partnership with Marie Curie, Bradford Teaching Hospital Foundation Trust, and Social Finance. It aims to improve inequalities in end of life care in the Bradford area. REACT supports patients in the Emergency Department (ED) and also through discharge to Community REACT for 72 hours of support, or via admission to Bradford Royal Infirmary (BRI) palliative care services.

Aim The aim of this evaluation was to explore the extent to which REACT had met its aims, objectives, and outcomes, and what factors influenced this.

Method Qualitative data (9 interviews with service users and 18 with healthcare professionals) were thematically analysed based on the aims, objectives, and outcomes of the service. This was supplemented by a secondary analysis of KPI data.

Results REACT is contributing to a reduction in unplanned hospital admissions in Bradford Royal Infirmary. This finding was evidenced in our analysis of bed days data versus a matched control and in interviews with service users and staff. REACT supports patients and people close to them to have improved quality of life. They have improved comfort, reduced pain, and better peace of mind.

REACT has also facilitated a change in culture, practice, and attitude about palliative care in BRI.

Enablers of impact include the implementation of new processes and procedures, the confidence and expertise of staff, and early collaboration with existing healthcare providers. Barriers to impact include an underestimation of time required for non-clinical work, issues with data, and a lack of proactive engagement with minoritised communities.

Conclusion REACT is an effective service that delivers high quality, holistic, and person-centred care that enables a proportion of patients to avoid future unplanned hospital admissions. There have been some challenges faced by REACT but service users reported an overwhelmingly positive experience.