North Devon Hospice recognised the important role that GPs play in ensuring that patients and their loved ones benefit from the full suite of services that the hospice provides. North Devon Hospice also recognises the workload of GPs means that throughout a given year their awareness of hospice services, particularly for non-cancer patients, may vary significantly. Ultimately this leads to unmet need.

To address this we sought a solution which enabled engagement with the GPs above and beyond the time constrained, patient focused meetings that our clinical nurse specialists have with all of the GPs across North Devon. We also felt that it is not the responsibility of the CNSs to hold the entire relationship management with each GP Practice.

Against this backdrop we developed the annual GP referral report for each GP Practice. This report included:

• Top 10 referrers by GP Practice: a league table of where each GP practice sits against others on the number of referrals;

• Primary reason for referral;

• Secondary services that patients then accessed following initial referral: thereby demonstrating the extra support that is wrapped around the patient once they have been referred;

• List of the GPs in each practice who made the referral;

• Diagnosis of patients split by cancer v non–cancer: opportunity to highlight that the hospice is not just about cancer;

• Number of patients who received our Hospice to Home service.

The results were very tangible. We saw between a 10%–30% increase on our referrals per practice and then a higher referral for non-cancer conditions in the three months after the report was issued.

We have now timed the publishing of the report to capture the gap in the year when we as a hospice are not active in each practice either through education sessions or through the annual visit by the CEO, Medical Director and Director of Care.