Background The Scottish Partnership for Palliative Care’s ‘Every Story’s Ending’ report (2021) recommends that care homes receive support from local resources to provide palliative and end-of-life care. Despite this, many care home residents still reach the end-of-life following an emergency admission to hospital (Broad, Gott, Kim, et al. Int J Public Health. 2013;58:257–67). When called by care home staff, ambulance crews often need to take a resident to hospital as there is a gap in available local resources to enable them to remain at what is their home. St Columba’s Hospice Care has collaborated closely with the Scottish Ambulance Service (SAS) to bridge this gap via the Virtual Ward (VW) service, offering support to care homes to enable an alternative to hospital or hospice admission for those who wish to remain at home.

Aim To use a case-study to consider how collaboration between ambulance services and palliative care specialists may facilitate preferred place of care and death for care home residents.

Method Detailed case note review to compare outcomes for a care home resident before and after the implementation of collaborative working between the VW and the SAS.

Results Mrs M experienced several distressing hospital admissions in short succession for uncontrolled seizures. Once collaborative working between VW and SAS was implemented, the SAS were called to assess Mrs M having a subsequent seizure. The crew recognised Mrs M’s preference to remain in her home so liaised with the VW and care-home staff. Mrs M was admitted to the VW the same day, her family and care home staff were fully supported to manage her complex palliative needs, further ambulance calls and hospital admissions were avoided thus allowing her to die in her preferred place.

Conclusion Palliative care specialists in the VW model working collaboratively with SAS can lead to better outcomes for care-home residents, helping them to achieve their preferred place of care and death.