Increasing the number of adults on a palliative care end‑of‑life register: a quality improvement project

Background/Aims Identifying patients at the end of life can facilitate easier access to support and reduce unnecessary emergency care admissions. This study aimed to increase the number of adults on the palliative and end-of-life care register by at least 10% in 20% of primary care practices in an English integrated care system. Methods A quality improvement project was carried out, using the Model for Improvement, with plan-do-study-act cycles. A hospice within a UK integrated care system added standard wording and system codes to letters sent to patients’ primary care provider. The number of patients on the palliative and end-of-life care register was monitored monthly between September 2022 and April 2023. Results By the end of the study period, the number of patients on the palliative and end-of-life care register had increased by >10% in 20% of practices. Conclusions Adding a recommendation to add a patient to palliative and end-of-life care registers on letters sent to primary care providers can lead to an increase in the number of patients being identified to be in the last year of their life.