Background In April 2018, the hospice was commissioned to deliver care packages to patients who qualified for continuing healthcare (CHC) funding under fast track provision. Initially the project offered five virtual beds which enabled patients with a deteriorating and life limiting illness to remain at home by preventing avoidable admissions to hospital and facilitating early discharge from in-patient care, either hospital or hospice.

Aims of the service

• Ability to provide rapid discharge from acute sector;

• To deliver a comprehensive fast track CHC service for service users with palliative and end of life care needs based on their clinical need rather than diagnosis;

• To support people to live and die in their preferred place of care especially where this is identified as their own home;

• To prevent avoidable admission to hospital.

Method Commenced provision of five virtual beds in April 2018 and the level of care was based upon clinical need rather than being time specific. Care was provided by Health Care Assistants (HCAs) with the necessary skills to support this vulnerable group of people with specialist assessment being carried out by Registered Nurses. Care was offered up to a maximum of four times per day and was personalised and tailored to meet the needs of patients.

Results The service demonstrated:

• The ability to be responsive to patients’ preferred place of care/death;

• The ability to support Community Teams;

• feedback from both patients and carers has been overwhelmingly positive;

• The smooth transition between hospice services including in–patient and day service.

Conclusion Following evaluation of the service and the positive feedback received from both staff, patients and relatives, the CCG have commissioned a further five virtual beds.

As of the 1 April 2019 the service can now provide care for 10 patients with a maximum of four visits per day.