PP-11 Marie Curie responsive emergency assessment and community team (REACT): widening access and knowledge

<h3>Introduction</h3> Bradford’s Marie Curie REACT provides in-reach into the Emergency Department (ED) to proactively identify patients with palliative care needs and prevent hospital admissions. <h3>Aims</h3> REACT aims to address inequity of access in Bradford, where an estimated 1000 patients die annually without access to palliative care, and to reduce the number of days spent in hospital. <h3>Methods</h3> Senior REACT clinicians in ED assess patients and manage their palliative needs, whether returning home or being admitted. The community arm provides a short-term multi-disciplinary virtual ward to support discharge from ED and refer on to other services. <h3>Results</h3> Average unplanned bed days in final year of life reduced from 38 to 18. Widened access: REACT is the first contact with any palliative service for 35% of patients. REACT caseload mirrors the age, ethnicity, deprivation and disease profiles of those who die in Bradford. Improved ED staff confidence in managing palliative care patients, improved staff wellbeing and reduced moral distress. Widened knowledge of palliative care by non specialists: improving their ability to recognise patients with palliative care needs, deliver advance care planning and seek specialist support when needed. <h3>Conclusion</h3> The REACT model of ED in-reach with a community virtual ward has a wider impact than solely reducing hospital admissions. ED is the hub of the hospital and seeing patients from an unselected take has reduced inequity and widened access to palliative care. In addition, a visible palliative care presence has reminded colleagues from across multiple specialties of the broad reach of palliative care and the impact of good holistic assessments and advance care planning in urgent care settings. <h3>Impact</h3> The REACT model has the potential to be adapted and adopted in other areas depending on the needs of local population and the services available.