Background This innovative project has brought together the knowledge and expertise of providing palliative nursing care from an NHS Trust with a local charity dedicated to ensuring patients have choice within their local area.

Aims From its inception at a public meeting to providing care to patients in a purpose-built six-bed unit, this project aims to provide quality care in a non-institutionalised setting. Its innovative approach comes from the nurse-led model where the patient’s own local GP retains oversight and leadership of the medical care. It has been provided within a specified financial envelope, utilising the valuable skills of volunteers to support the care provided by nursing and support.

Methods The team has overcome and embraced a range of challenges. These have included:

• Ensuring positive engagement with local GPs – this includes raising awareness of a new service to encourage referrals, and engagement about offering a different approach to palliative and end of life care

• positive engagement with other referrers – the team has worked hard to establish their presence in the local community, even visiting every single ward of a neighbouring hospital to encourage engagement and referrals

• continuing healthcare resources – balancing the ethos of supporting patient choice with the availability of other health resources in the community through other care providers

• a bespoke staffing model, which meets financial efficiencies while ensuring an effective response to local needs. This has also given autonomy to Band 6 nursing staff and development opportunities for students.

Results Our innovative model has supported:

• increased patient choice in the locality good

• engagement with other professionals

• an equal balance between physical and spiritual care.

Conclusions The project has proved the innovative concept of a nurse-led model can effectively support greater patient choice and improve experience in a community setting.