Background Since 2015, St Elizabeth Hospice has been developing Zest, a unique and innovative adult hospice led transition and young adult palliative care model. Zest aspires to be a regional hub and spoke model, providing short breaks, advice and training for other hospices.

Prevalence is increasing (Gibson-Smith et al. Making every young person count: estimating current and future prevalence of young people with life-limiting and life-threatening conditions in England: final report. 2021) and nationally there is a shortage of services able to meet the complex care needs of young adults (Knighting, Bray L, Downing, et al. J Adv Nurs. 2018; 74(8): 1888–98; Knighting, Pilkington, Noyes, et al. NIHR Journals Library; 2021 Feb). A successful Masonic Charitable Foundation Hospice Grant application is enabling Zest to develop as a Centre of Excellence for transition and young adult palliative care.

Aim Zest strives to enable equitable palliative care support for young adults and their families across East Anglia, including a regional short break service using personalised funding, and a training centre.

Method

• Establishing a new Advanced Clinical Practitioner role, enhancing the capability of Zest including non–medical prescribing and clinical skills training.

• Co–production, including ‘Zest Voices’ for families out of area.

• Increasing the capacity of the short break service.

• Providing training on service development, complex care competencies and bespoke offers to support community care packages.

• Working with ICBs across East Anglia, to influence local service developments, seek opportunities for collaboration and enable access to regional short breaks.

• Reviewing literature on Centres of Excellence to ensure Zest is ‘distinguished’ and meets the criteria (Elrod, Fortenberry Jr. BMC Health Serv Res. 2017;17(Suppl 1):425; Manyazewal, Woldeamanuel, Oppenheim, et al. BMJ Open. 2022;12(2):e050419).

Results

• Developmental Advanced Clinical Practitioner recruited and in training.

• Short breaks to be available for families in North East Essex and Norfolk by the end of 2024.

• Zest Training Centre launched.

• New drop–in service starting in Norfolk in July 2024 in collaboration with other hospices.

Conclusion Zest continues to innovate and improve palliative care provision for young adults. It is hoped that being recognised as a Centre of Excellence will provide opportunity for greater reach as we progress this specialist field.