42 Urgent response: evaluation of a hospice virtual ward pilot

Background Virtual Wards present a safe and efficient alternative to in-patient care. Patients approaching the end of their lives may have rapidly changing and complex needs which can result in potentially avoidable or unwanted hospital admissions. An End-of-life Virtual ward offers opportunities to increase the capacity for same day community assessment with ongoing daily monitoring and support for patients living with a life limiting illness during time of crisis (significant symptoms, rapidly changing the clinical picture, complex dying or suspected palliative care emergency). Method A one-year Hospice Virtual Ward Pilot is being undertaken in partnership with the Integrated Care Board (population 237 000). A daily huddle supports multi-disciplinary working and coordination of care. Increased capacity within an established integrated specialist palliative care service facilitates responsive, proactive care by experienced clinicians and increased hospice-at-home care shifts. Close working with other community providers enables efficient delivery of care. Ongoing PDSA cycles refine the model of delivery, with data and patient feedback collated. Results During the initial 3-month pilot (July – August 2023), there were 100 admissions (6 beds, average length of stay: 3.88 days.; occupancy rate 86%.; total bed days: 354 days). 78 remained at home, with 19 hospice admissions, 2 hospital and 1 Care Home transfer. 18 patients died in their usual place of residence, whilst supported by the virtual ward. Patients and family report high levels of satisfaction with care, and staff report improved job-satisfaction. Conclusion Hospice wards have the potential to provide same day specialist palliative care assessment for complex patient's during times of crisis, enabling early discharge, and preventing admission to inpatient beds. They providing care in keeping with the individuals values and preferences, and improving patient and care experience. This pilot will inform future models of specialist palliative care service delivery.