98 The impact of joint heart failure and palliative care MDT working

<h3>Background</h3> Heart failure is a progressive and life limiting illness affecting almost 1 million people in the UK. It is associated with distressing symptoms and an unpredictable trajectory, leading to reduced recognition of palliative care needs and multiple unplanned admissions involving invasive and futile treatments at the end of life. A monthly joint heart failure and palliative care MDT was set up involving hospital, community and hospice services including inpatient, outpatient and lymphoedema teams in line with revised NHS framework for integrated care systems (ICS). <h3>Method</h3> A retrospective review was performed of 50 patients’ records who were discussed at MDT to assess compliance with standards to support patients in receiving integrated palliative and heart failure care in relation to: Accessing specialist palliative care and heart failure services with holistic individualised assessment Evidence of advance care planning Identifying and achieving preferred place of death Contributing to prevention of unnecessary hospital admissions <h3>Results</h3> Notes reviewed of 50 patients discussed at joint MDT 45 known to community heart failure team 18 accessed community palliative care services 20 accessed day services at hospice 12 accessed hospice inpatient unit 16 accessed hospice based lymphoedema service 31 of the 50 patients had died at the time of audit Preferred place of death was achieved in 23 out of 25 patients where data was available <h3>Conclusion</h3> The joint MDT is supporting patients to access person-centred assessment, advance care planning and cohesive working in addressing palliative and end of life care needs for people living with heart failure in line with NHS framework for ICS. The impact is significant in reaching patients with heart failure who previously were not accessing joined up specialist care. The audit provides evidence of prevention of unnecessary hospital admissions and achievement of preferred place of death.