Intended for healthcare professionals

Feature The BMJ Awards 2016

Palliative care team

BMJ 2016; 353 doi: (Published 08 April 2016) Cite this as: BMJ 2016;353:i1991
  1. Nigel Hawkes, freelance journalist
  1. London, UK
  1. nigel.hawkes1{at}

Nigel Hawkes finds out how the nominees for the palliative care award are working to improve care and keep people out of hospital

Harrow end of life single point access

For people in their last year of life, fragmentation of care is a burden they can do without. “When we looked at care for this group, we found no continuity, nobody to take responsibility, and nobody to turn to in a crisis, particularly at the weekend,” says Nicola Davies, end of life lead for Harrow clinical commissioning group (CCG) in north west London.

The answer was to set up a single point of access—a telephone number available 24 hours a day and seven days a week for patients, carers, and healthcare professionals. Operated by St Luke’s Hospice, the number can be used to summon a rapid response team between 7 am and 11 pm for any patient registered for more than a year with a Harrow GP and identified as being in the last 12 months of life.

As well as providing a better service, the new system reduces hospital admissions and increases the proportion of patients able to die at home to almost 90%. “Nationally, in their last year of life people are admitted to hospital an average of three times,” Davies says. “If we could reduce that to two, we could save £1m a year. I hope we can do that—we’ve had a good start.” The service cost £246 000 (€305 000; …

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