Background There is national recognition that demand on palliative care services is undergoing rapid change. The shift in age demographics combined with increasing complexity requires a more adaptive approach to fulfilling the wishes of patients. NICE has previously suggested that as well as the traditional face to face visits during 9–5 that there should be telephone advice 24 hours a day. It goes on to say that face to face consultations outside of 9–5, seven days a week is desirable. Consequently the community team has led an initiative to remodel the current service into one which ’Patients were seen at the right time, in the right place and by the right person.’

Aims

• Restructure the community team to enhance flexibility, deliver additional capacity, to be able to visit patients at any time of day or night

• The Community Team needs the flexibility to visit patients at any time of day or night

• Introduce triage for all new referrals to ascertain the actual patient need and the speed at which a response is needed

• Evaluate the change in outcomes.

Methods 1. Utilised change management and best practice tools to alter working patterns and responsiveness

2. A baseline review was conducted prior to implementation of triage. Post launch outcomes were reviewed results on a monthly basis to ensure relevant standards and targets had been adhered to.

Conclusion We have received positive feedback from staff and patients regarding the use and deployment of triage. Of the new referrals received in May 2017 we have identified 6% of inappropriate referrals prior to first face to face meeting. In 3% of cases avoided inappropriate admissions to hospital and delivered an urgent response to 21% who previously may not have received a visit for 6.4 days