Background Our hospice covers a geographical area with a high elderly population in both affluent and deprived areas (Sleeman, Davies, Verne et al., 2016). Residents living in deprivation are less likely to have access to palliative care services (Care Quality Commission, 2016). Local data shows that 16% of patients in 2017 choose hospice as their preferred place of care (PPC) but only 4.5% of annual deaths in our locality occur in the hospice.
Aims Tendring residents theoretically have equal access to hospice beds but local data demonstrates that they are half as likely to die in a hospice than residents in Colchester. This suggests an inequality in provision and unmet need in the Tendring area (Help the Hospices, 2013). In order to address this shortfall, our hospice and the local community provider have worked in collaboration to provide additional specialist end of life care beds.
Method Patients are admitted to the community hospital nurse-led unit where we aim to provide high quality, holistic care. Patients are admitted either from the community or transferred from the local acute hospital. Day to day care provision is provided by the nursing staff on the ward with support being provided daily by hospice clinical nurse specialists (CNSs). By working in collaboration residents are offered the choice of a local community hospital as their PPC to allow them to be cared for closer to home. The CNSs have also provided formal training to the multidisciplinary team.
Results Since September 2017 53 patients have benefitted from this service which has provided additional access to local community beds with support from a specialist palliative care team. Collaborative working has enabled adequate symptom control, appropriately supported discharges or a peaceful death to achieve their PPC.
Conclusion This collaborative service has enabled access to additional specialist palliative care beds and supported patients to achieve their preferred place of care.
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