{
  "abstract": "Background In 2023, 46% of people in Scotland died in hospital settings, 4,014 in the Lothians (National Records of Scotland. Vital Events reference tables 2023. 2024 July 30 [internet]). Many people wish to be cared for and/or die at home (Johansson, Pask, Goodrich, et al. Time to care: findings from a nationally representative survey of experiences at the end of life in England and Wales. Marie Curie; 2024) and admissions close to end-of-life may even cause harm (Davies, Booker, Ives, et al. Palliat Med. 2024;38(8):806-817). Marie Curie Enhanced Hospice Care at Home (EHC@H) was launched May 2024 with financial support from the Scottish Government to support complex, unstable palliative patients to be cared for at home. EHC@H provides short-term access to 24/7 support in a patient’s home (including care home). The service is staffed by a team of nurses and medics with access to allied health professionals and other specialised support.Aims Reduce unnecessary acute admissions and facilitate acute discharge at end of life.Provide responsive palliative care for patients, families and carers with complex physical and psychological needs in their homes.Support patients to achieve their preferred place of care.Methods Initial mapping of service need and gap in existing provisions. Development of 7-day, 24 hr service providing scheduled and unscheduled support. Qualitative and quantitative evaluation embedded from service initiation.Results Year 1 annualised as of March 2025 projected 218 admissions avoided, saving an estimated £1,077,480.Supported discharge from acute setting for those previously too symptomatic.Supported preferred place of care and death.Average return on investment: 74%.Overwhelmingly positive feedback highlighting practical and emotional impact for service users.Conclusion The service launched successfully and is having a profound impact on patients and those close to them. Service figures suggest a strong return on investment, significant avoidance of acute admissions, and subsequent bed days saved. Service users with urgent palliative need can stay at home for comprehensive, tailored treatment and emotional support. Because of this, patients and those supporting them feel relieved, more able to cope and able to remain at home.",
  "authors": [
    {
      "affiliations": [
        "Marie Curie Hospice Edinburgh, Edinburgh, UK"
      ],
      "name": "Emma Young"
    },
    {
      "affiliations": [
        "Marie Curie Hospice Edinburgh, Edinburgh, UK"
      ],
      "name": "Audrey Geary"
    },
    {
      "affiliations": [
        "Marie Curie Hospice Edinburgh, Edinburgh, UK"
      ],
      "name": "Rachel Kemp"
    },
    {
      "affiliations": [
        "Marie Curie, London, UK"
      ],
      "name": "Hannah Leach"
    }
  ],
  "title": "P-133 Enhancing hospice care at home: bridging inequalities in care provision, reducing admissions and promoting preferred place of care and death",
  "uid": "885901a5-88ca-535a-874d-8d6b5ef0983c"
}