Background A comprehensive review was carried out in 2013/2014 with the support of Macmillan Cancer Support focusing on workforce development for the Palliative Care Specialist Nurse team working in the community. It recommended the provision of a more responsive and accessible service for patients, carers and health are professionals by developing a bespoke, dedicated Triage and 24/7 Advice Line.

Aims To analyse and explore the most effective referral process to deliver a more responsive and accessible service for all patients who are referred to the Palliative Care Specialist Nurse team.

Method In September 2016 a two-year project commenced which involved four phases:

• Understanding current practices

• Analysis of the literature, audits and clinical practice in other hospices

• The transformational phase which included the development of a bespoke robust model, implementation of systems and processes ready for Test and Launch

• Evaluation of the model, impact analysis on the organisation, patient and carer outcomes.

Results The results of the test in May 2017 demonstrated a clear need for a dedicated Triage referral service Monday to Friday staffed by experienced nurse specialists and administration support. The focus during this period was on defining patient need and priority, response, team capacity, ability to give specialist symptom management advice and support, referring and signposting to other appropriate services, reduction in hospital admission, patient, carer and health care professional satisfaction and improved caseload management. These initial service outcomes have shown significant increase in responsiveness and improved assessment of patient need and priority. The process was robust and is transferrable across other internal services at the hospice which could impact on time and cost effectiveness.

Conclusion The dedicated Triage Service will launch 26 June 2017 followed by the launch of the dedicated Advice Line in October 2017.