6643 Seamless family centred perinatal palliative care

Objectives Forget Me Not Children's Hospice was the first in Europe to employ a midwife and neonatologist to work alongside the wider team to provide seamless specialist perinatal support. The aim is to establish a relationship with families at the earliest opportunity, enabling them to navigate through the uncertainties of the pregnancy and neonatal period. Each family is on an individual journey and is offered bespoke holistic care. Multidisciplinary team working enables families to be supported in the most appropriate way by the most appropriate people throughout their journey. Methods Families referred antenatally are offered home visits, support at scans and appointments and the opportunity for antenatal memory making. Antenatal care planning over several visits allows for detailed exploration of the uncertainties faced and the family's hopes and expectations. The families continue to be supported by the hospice midwife for six weeks after delivery. The neonatologist remains involved in the care of the baby and family for as long as required, alongside the wider perinatal team. If the baby dies, the family are referred on to the family support team who provide a tiered approach to bereavement support. Many families who suffer a perinatal loss become pregnant again within a short period. Support for these families comprises peer support groups and ongoing support by professionals who already know their story. Results The perinatal service receives between 50 and 85 referrals per year. Antenatal referrals are increasing annually and are made by a wide variety of professionals, with paediatricians/neonatologists being the leading referrers. The proportion of neonatal referrals made to the hospice are decreasing, which indicates that families are being referred earlier in their journey. Although most babies die within the neonatal period, more babies are surviving and going on to receive support from the wider perinatal team. Around 28% of antenatal referrals to the hospice remain alive beyond the neonatal period. This helps to break the misconception that hospices are primarily about death. Feedback from families highlights that established relationships with professionals allow them to be their baby's primary caregiver with continuity of care and clinicians knowing the family and their story being vital. Conclusion Data and feedback from families show the importance of midwifery and neonatal roles within a children's hospice. The model of support described helps to reduce barriers to care delivery, enhancing families' experiences. Midwifery and neonatal roles within all children's hospices should be the gold standard.