PP-14 12 months of enhanced hospice care at home virtual beds: clinical, systemic and personal impacts of complex care provision in the home

a:2:{s:4:"lang";s:2:"en";s:7:"content";s:2834:" Introduction In 2024, 3,825 people (45%) died in hospital settings in the Lothians.1 Many people wish to be cared for and/or die at home2 and admissions close to end-of-life may cause harm.3 Marie Curie Enhanced Hospice Care at Home (EHC{at}H) was launched in May 2024 to support complex, unstable palliative patients to be cared for at home, providing short-term access to 24/7 support in a patient’s home. The service is staffed by a team of nurses and medics with AHP and other specialised support. Aims 1. Reduce unnecessary acute admissions and facilitate acute discharge at end of life 2. Provide responsive palliative care for those with complex physical and psychological needs in their homes 3. Support patients to achieve their preferred place of care Methods Marie Curie’s Impact and Evaluation team conducted a mixed-Methods evaluation of the first year of service, analysing quantitative and qualitative data including: OACC suite outcome measures for whole patient cohort 19 in-depth interviews with service users, and 18 with staff 12 months of activity and financial data Results 179 acute admissions avoided; 1,378 bed days saved; £1.13m costs saved Patients move from ‘unstable’ to ‘deteriorating’ or ‘dying’ phase of illness, with decreased physical and psychosocial symptom burden Profound positive physical, practical and emotional Impact on service users Strong integration into local ways of working Conclusion EHC{at}H is a powerful model of care in the home for patients with complex palliative care needs, tailored to local needs and systems, and provides key learnings for delivering complex palliative care in the home. Impact Skill mix of the Lothian EHC{at}H clinical team helps stabilise complex patients, improving physical and psychosocial symptoms, and offering profound relief and comfort to them and those close to them. The service avoids acute admissions, relieving system strain and shows strong return on investment. References National Records of Scotland, Vital Events reference tables 2023 [Internet]. 30th July 2024 [cited 18/02/2025]. Available from: https://www.nrscotland.gov.uk/publications/vital-events-reference-tables-2023/ Johansson, T et al. Time to care: Findings from a nationally representative survey of experiences at the end of life in England and Wales. 2024. Available from: experiences-at-the-end-of-life-in-england-and-wales Davies R, Booker M, Ives J, Huntley A. How do primary care clinicians approach hospital admission decisions for people in the final year of life? A systematic review and narrative synthesis. Palliative Medicine 2024;38(8):806-817. ";}