It has been identified that to meet future requirements for hospices they need to review their services, beginning with placing patients’ goals for living at the centre of holistic support. Hospices need to create a culture of enablement and provide patients with greater choice, independence and dignity in advancing illness. They need to respond to ever increasing demand for palliative and end of life care within the demands of financial restraint (Hospice UK, 2017).

The aim of changing current service to ‘Drop-in’ is to provide a supportive nurse-led environment for adults and their carers living with a life-limiting illness. Promote a sense of wellbeing and a positive approach to living with their illness.

The services/support we provide:

• Patient centred: ‘pick and mix’– attend as often or little as needed. No appointment required;

• Goal–orientated;

• Workshops e.g. Breathlessness management/falls prevention/fatigue management/mindfulness/nutrition/advance care planning;

• Physiotherapy;

• Complementary therapy;

• Counselling;

• Chaplaincy;

• Social work;

• Peer support;

• Creative activities;

• Patient/Carer/Staff Meetings to ensure we are providing what patients/carers want.

Findings since service developed Patients and carers attending Day Hospice have increased dramatically - increased by 250% on the ‘Drop-in’ day.

• Some patients are very ill – ‘fear of the hospice’ feeling that it is a ‘place to die’, however, when patients and carers are shown around the hospice and advised about the services/support we offer, they feel reassured that the hospice is here for many reasons;

• Increased awareness of the service from Acute Trust/Specialist Nurses who advise patients to attend;

• We network very closely with Primary Healthcare Team and signpost patients and carers to other services;

• Reduced costs – less staff required/do not provide transport or meals.

The service has evaluated very well. Patients have quoted ‘fantastic service’; ‘Didn’t know where to go - thank you I feel so much better’.