4 Moving towards new models of hospice care: evaluation of a hospice/acute trust partnership

<h3>Background</h3> In December 2022 a partnership group was established between North Tees &amp; Hartlepool NHS Foundation Trust and Butterwick Hospice with the purpose of reopening in-patient beds following a period of dormancy. Our aim is to provide adult inpatient palliative and end of life care, improve flow and capacity within the acute trust, deliver patient choice around preferred place of death and to offer more patients the opportunity of hospice care. <h3>Methods</h3> We created a consultant supported, nurse led model. The ward is managed by a hospice clinical manager and staffed with nurses and healthcare assistants on rotation from the hospital. Daily patient assessment and management is undertaken by a nurse specialist from the Trust’s palliative care team. Initially, two beds were opened allowing transfer of patients from the hospital for end of life care. We now have four beds providing both end of life care and symptom management. There is a mobilisation plan in place to establish eight beds and to admit patients from the community. <h3>Results</h3> From 21st August 2023 – 30th September 2024 we have admitted 97 patients. Over 70% are transferred the same day, and we have facilitated admissions from ITU and ED. 46% have non – malignant disease, including stroke and dementia. <h3>Conclusion</h3> Our successful partnership offers patients the choice of hospice care and in doing so has supported the acute trust with some of their pressures. The rotational model is upskilling the workforce across both organisations. We have demonstrated that patients can be cared for by our skilled CNS team, with consultant support. Our model has provided hospice care to groups who may not have not accessed it, including admissions direct from ITU and ED. We have also cared for high numbers of patients with stroke or dementia, who have traditionally been underrepresented in hospice inpatient units.