Background Collaborative End of Life Care improvement across a Clinical Commissioning Group had been supported by two hospices part funding the CCG’s Project Lead. Serving one of the oldest populations in the UK, with people over 85 being 10% more likely to have an acute admission ending in death, a consistent approach, strategy and pathway for end of life care were needed.

Aims To develop a centralised, single point of access for patients, their loved ones and carers that would coordinate care, provide advice and help people to reach the most appropriate care and support. The service aims to reduce unscheduled admissions to hospital at end of life, enable more people to die in their preferred place and improve communication and co-ordination between all care providers by the creation of a locality electronic end-of- life-care register.

Method The Community and Acute Trusts worked with three specialist palliative care (SPC) providers including the two hospices to develop a business case for the Collaborative EoLC Hub; this was approved and funded by the CCG. The Community Trust established the co-ordination centre and the three SPC providers are sub- contracted to deliver specialist palliative care advice 24 hours a day, seven days a week. The SPC providers operate a shared on-call rota for clinical nurse specialists and consultants, thereby maximising opportunities to share resources.

Results The co-ordination centre was launched in October 2016, ensuring full engagement with the local health and social care community and the public. Over 600 people are registered but earlier identification of people during the last year of their lives requires more work across the whole health economy.

Conclusions Through collaboration, hospices can deliver solutions to enable CCGs to improve end of life care across their communities and reduce inappropriate admissions to hospital at end of life.