Background/context Maximum impact in terms of achieving patients preferred place of care may be gained by focussing future service development on extending and improving care at home. This also ensures on-going collaboration between NHS and other providers of end of life care.

Since September 2011 the Hospice has been developing the ‘8 to 8’ service which provides a night nursing service for existing Hospice patients and more recently, through partnership working with other healthcare providers for dying patients not known to the Hospice.

Main Aims

• To optimise the opportunity for patients requiring end of life care who wish to stay at home to remain in their preferred place of care

• To prevent unnecessary admissions to hospitals

Approach used The service is delivered by both bank and permanent members of staff and includes both registered nurses and senior health care assistants. All staff are inducted by the Hospice and given the requisite palliative care skills. The service is led by a clinical nurse specialist who supports and co-ordinates the allocation of staff according to clinical need. The nurses remain with the patient throughout the night.

Outcomes Evaluation demonstrates that the service has exceeded expectations. Most patients referred to the 8 to 8 service are for terminal care with 95% of patients achieving their preferred place of death. The service now delivers 50 nights per month across the catchment area.

Application to hospice practice The 8 to 8 service has been commissioned by two clinical commissioning groups since its inception and continues to expand and build on its success. It is delivered by specially trained nurses who are compassionate, efficient, caring and greatly improve the patient experience. Increasing numbers of complex patients are now able to be cared for in their preferred place of care.