Background A collaborative, innovative and highly cost-effective approach has been adopted by Hospice of the Valleys (HoV) and Aneurin Bevan University Health Board (ABUHB) where palliative patients are treated on one ward under the care of a specialty doctor in frailty and an advanced nurse practitioner/independent prescriber employed by Hospice of the Valleys. Direct admissions from community into a community hospital setting are facilitated by HoV. This has been established to appropriately treat palliative patients closer to home reducing admission into acute settings and provide a local alternative to an out of area inpatient hospice.

Aim The aim of this model is to operate a short stay solution for palliative complex symptom management and to achieve a person’s preferred place of death (PPD) on one ward with the potential to improve service coordination, efficiency, quality outcomes for patients and develop nurses’ skills and knowledge.

Method An audit was created and undertaken using quantitative data from information collected as part of standard care for all patients referred to HoV. Data includes community admissions, referrals, deaths, PPD. Educational sessions facilitated by HoV were offered to enhance knowledge of palliative care and encourage best practice. Qualitative data was collected from feedback and participatory observations. All data was collected on a monthly basis and collated in a yearly report.

Results Patients were appropriately referred to HoV. Audit results indicate referrals to HoV (n=136). Direct admissions from community (n=16). Deaths supported by the service (n=83). 75% of all ward staff attended educational sessions.

Conclusion The collaborative model has positive reported outcomes for both ABHUB and HoV. Notably patients and their families have benefitted from this innovative approach. Being able to provide care closer to home and preferences around PPD is fundamental in supporting people to achieve their end of life goals.