Background Older people living in care homes are living with complex co-morbidities and frailty. In NHS Highland older people (85+) and people living with dementia are more likely to die in a care home. Approximately 800 people living in a care home will die every year in NHS Highland with the median length of stay being 1.3 years. Emergency hospital admission increases for people in their last year of life with 68% of people having one or more admission.

Aim To provide a 24/7 support and clinical advice helpline for people living with frailty in care homes and those who care for them.

Method A quality improvement approach was undertaken to implement a 24/7 clinical advice and support ‘Palliative Care Helpline’ (PCH) across the 66 care homes in NHS Highland area. Key performance indicators were collected allowing change to be measured. Stakeholder analysis resulted in the setup of a working group which co-created and engaged with social care staff.

Results Results from care at home staff (n=49), care home staff (n=3) and staff attending a focus group (n=4), indicated staff felt isolated, confused about unscheduled care pathways, and spent a long-time navigating pathways. They wanted to ‘phone a friend’ to check thought processes, ask advice and get support. Since its launch in July 2023, 408 (19% total) PCH calls were received from care homes regarding 173 people. Subsequent feedback indicated that care home staff used the PCH for support rather than calling an ambulance.

Conclusion Due to the level of calls and the positive feedback, the aim of the project has been met. The project has demonstrated the requirement for further roll out to care at home staff and further need to understand if 999 calls and admission to hospital have been reduced.