Background and Context Nightingale House Hospice have offered a 24-hour telephone advice line to patients and their carers in North East Wales since the year 2000. Predominantly the area covered is urban with good access to a variety of health and social care services.

In 2010 the hospice were asked to provide a similar service providing advice on palliaitive care/specialist palliative care to health care professionals across all geographical areas of North Wales acting as a triage centre for palliative medicine consultant advice, this service was not made avaialble to patients and families due to concerns regarding potential volume of calls. This introduced a population located in large rural areas with more sporadic access to services.

Aim & Approach The purpose of the audit was to encourage discussions about the ethics of delivering a two tier service based purely on geography but also considers the context of the calls in terms of the services available to patients within each locality in terms of model of service provided and also the hours of operation/delivery

Outcomes This presentation details the findings of an audit of the advice call forms completed reviews and compares the data collected from both geographical areas covered by the advice line, considering the volume of calls from both areas, the time and duration of calls and also the reasons why people called.

Application to practice The audit recognises some limitations in the method by which data is currently collected and reviewed providing guidance for the future in terms of what do we need to know in order to measure the impact and outcome of the provision of this service to patient s and their families.

The work also draws conclusions for practice in terms of identifying current need within our locality.