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O-19 Driving change. experiences in co-commissioning
  1. Karen Chumbley
  1. St Helena Hospice, Colchester, UK


Introduction Hospices need to establish their role as a solution to the future challenges in End of Life Care and collaborate with other health providers are to ensure that hospices remain influential in the NHS of the future.1 Commissioning is a pivotal system for ensuring the correct services are provided for the local community,2 and commissioners are encouraged to develop joint commissioning systems.3

Aims The hospice wanted to have a central role in driving improvement in End of Life Care across our locality, widening the spectrum of those who benefit from high quality, co-ordinated care.

Methods The hospice became a co-commissioner with the local CCG in 2014. As well as the specialist palliative care service, we have responsibility for the local electronic patient register and a 24 h single point of access. We commission specialist palliative care for young adults from another local provider and we work in partnership with GPs via a local grant, to promote identification of people for the end of life register and record their choices and care preferences.

Results We have established a key position to influence palliative care policy and delivery in our locality.

Hospice referrals have increased by 25% and the proportion of local deaths in usual place of residence have increased by 10% over the last 4 years, placing us in the top 10% of CCGs in England.

Conclusion Co-commissioning is an effective way for hospices to influence local care quality and drive up standards in end of life care in their locality. Partnerships with primary care reach a greater proportion of those in the last year of life than hospice services working in isolation.


  1. Future ambitions for hospice care: our mission and our opportunity. Help the Hospices. 2013

  2. End of Life Care Strategy: second annual report, 2010

  3. RCGP Commissioning Guidance in End of Life Care. RCGP. 2013

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