Background In a bid to use nursing resource more effectively and improve equitable access to specialist palliative care advice, three East Sussex hospices are collaborating (National Palliative and End of Life Care Partnership. Ambitions for Palliative and End of Life Care: A national framework for local action 2021–2022; Hospice UK. Future Vision Programme – Discovery Phase. 2020) to develop Hospice Line, a shared 24/7 telephone support line. Our first milestone was to pilot an integrated Clinical Nurse Specialist (CNS) to provide dedicated clinical support to hospice telephone teams at weekends. The rationale for CNS to pioneer cross-organisation clinical collaboration is based on their expertise and central role in community palliative care services (Howell, Hardy, Boyd, et al. Int J Palliat Nurs. 2014; 20(5):246–53).

Aims To establish the feasibility of CNS to provide clinical advice for unknown patients registered in other hospices and to evaluate the effectiveness of the support, alongside generating a culture of sharing knowledge and expertise between hospices (Husband. Br J Community Nurs. 2008; 13(1):26–30).

Method A CNS from each hospice supported the design of the pilot, developing an escalation tool for telephone support staff and specifying the information they would need from patient records using a shared SystmOne module. To evaluate the pilot, we collected quantitative data from SystmOne and qualitative data from a feedback questionnaire completed by CNS and telephone support staff after each call (Cook, Wittich, Daniels, et al. J Med Internet Res. 2016;18(9):e244).

Results

• 80 calls escalated to CNS (12% of total).

• 78 calls (98%) fully or partially resolved by CNS.

• Of 11 partially or unresolved calls, only 3 were owing to limitations of Hospice Line.

• 17 potential hospital admissions avoided.

• 97% calls responded to within 20 minutes.

ResultsQualitative feedback evidences high levels of satisfaction with the CNS support from telephone advice staff. There has been a positive impact on the workload for doctors on call at weekends.

Conclusion The pilot demonstrates that the Hospice Line model is delivering responsive and effective care to patients across the three hospices. We are now ready to move to the next stage of fully integrating telephone support services.