Background A review has identified the strength of the existing Hospice at Home service but weakness of contractual arrangements. The service has evolved from providing bridging to one which provides the initiation of all fast track care packages. The hospice has thus invested time and finance to supportdelivery of statutory CHC services.
Aims Pilot a dedicated hospice-led fast track brokerage service retaining current responsiveness and quality but delivered with 100% cost recovery for the hospice.
The pilot will respond to the NHS Long Term Plan (NHS England, 2019) and local CHC Strategic Improvement Plan (2019) requirements especially around expenditure by maximising the benefits of co-locating end of life and palliative care services.
Method Twelve month pilot will explore the:
timeliness, quality and equity of access of a hospice–led service (Marie Curie, 2017; Marie Curie, 2019);
interface between this service and a traditional hospice at home service;
benefits of co–location with other hospice services;
impact upon locality expenditure.
The service will receive, triage and assess all referrals for fast track CHC and initiate care.
Out of hours referrals will be picked up by the Hospice in the Home Service which will bridge care for a maximum of 72 hours.
Results A set of key performance indicators including the following will be used to measure outcomes:
Range of packages delivered;
% of referrals who have care started within 24 hours of being able to receive care;
% of referrals that require Hospice in the Home Service to bridge care;
% of patients utilising Personal Health Budgets.
Our intention is to demonstrate that timeliness and quality is best delivered by a hospice-led service and that this can positively impact equity of access and expenditure.
Conclusion The pilot demonstrates collaboration, has potential to positively impact patient outcomes, responds to policy requirements and could inform future commissioning recommendations. Since commencement of the pilot, initial results have identified potentially some significant benefits to patients, providers and commissioners. Therefore the poster presentation will focus on perceived outcomes.
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