Background The complexity of patients in the hospice has significantly increased over the last five years, and includes non-cancer diagnoses. There is an increasing number of patients who are now admitted to hospices with a non-cancer diagnosis e.g. COPD, end stage heart and renal disease. Patients who are transferred from hospitals to hospices have increasingly more diverse and specific treatment regimes.

Why it is important?The 2016 End of Life Care audit in hospitals acknowledges that there has been steady progress in the care of dying people since the previous audit carried out in 2013 and published in 2014. However as in the past the provision for palliative care is inconsistent across the country, this is particularly true of out of hours. Although it is unfair to directly compare hospices and hospitals, the advantages of sharing specific knowledge and skills across the two is clear.

What is currently being done?A one-week nurse exchange; centred on observations, is agreed between St Ann’s Hospice and the Renal, Cardiology, Haematology and Respiratory departments of Central Manchester Foundation Trust. Discussions are underway to include Gastro-enterology. The programme adopts a hands-on approach where knowledge and skills are shared through shadowing and observations.

Evaluation Following on from the renal exchange programme last year, a new evaluation form has been produced that captures the data in a more quantitative manner, thus allowing outcomes to be more auditable.

Overall objectives

1. Equip St Ann’s staff with the skills and knowledge to deal with more clinically complex patients

2. Raise awareness of individualised end of life care in a hospice setting.

The future This is an ongoing project, aiming to cascade across all hospital specialities, with a view to develop end of life care ‘Champions’ in each speciality. Our goal would be to see this partnership program replicated in other organisations.