IntroductionTransfer of patients to nursing homes for end of life care is often difficult. Patients and carers express anxiety and feelings of abandonment during the process. At The Hospice of St Francis we reviewed 10 hospice discharges in order to plan the introduction of transitional support volunteers to regularly visit patients and carers following transfer. Data is presented from our review of 10 discharges to nursing homes.Aims▶To identify if there are predictable /repeated issues causing distress in the transfer process.▶Whether continued involvement of a ‘familiar face’ would benefit a patient/carer in the transfer process.▶To work in partnership with nursing homes to reduce transitional anxiety.MethodWe reviewed 10 discharges from The Hospice of St Francis to 5 nursing homes (Aug ‘10 – March ‘11). Focusing on timeliness, carer/relative involvement and stage of illness at transfer.ResultsThe hypothesis is:▶The greater the involvement of carer/relatives the longer the transfer process▶All of the patients/relatives expressed some level of anxiety with the process▶For some anxiety and feelings of abandonment intensified post transfer leading to a move within days to another care setting.DiscussionThe analysis of 10 discharges from the Hospice to nursing homes highlighted that both clinical and psychosocial issues contribute to transitional anxiety. Nursing home staff welcome support in addressing the psychosocial needs of people at the end of life.ConclusionHospice care should not end once a person moves to a nursing home. We should focus more on reducing feelings of abandonment/loneliness for patients/carers transferred to nursing homes. The Hospice of St Francis Hospice will pilot a ‘transitional volunteer service’ for 12 months from May 2011 to May 2012.

• Personal care and support • Night careAlthough the elements of service are provided by different providers, they work together to ensure care is seamless 24/7. Outcomes The GCP was commissioned as a "test and learn project"; now in it's 3 rd year, the service has developed in response to local need and resources have been flexibly allocated to provide responsive, high quality care.Each provider has signed up to the success of the project and each has an equal stake in ensuring that the service meets its key performance indicators.The project has succeeded in supporting an increase in home and hospice deaths and a reduction in hospital admissions, length of stay and deaths. Application to hospice practice The model and contracting arrangements have attracted National interest amongst Hospices and commissioners, and has been cited as a model of good practice for others to build on.Thinking strategically about the role of hospices The GCP model is a natural extension of the Hospice service, producing efficiencies and quality improvements. With the current proposed model for palliative care funding, Hospices will need to take on the role as prime contractors in order to survive.

assistants' understanding of other HCPs' roles highlighted the need for further education in this area. Conclusions Whilst rehabilitation is not new to palliative care, the findings suggest this approach is going through a developmental and formalisation process. Increased interdisciplinary team working and further training in rehabilitative palliative care for hospice staff would be beneficial to embedding this approach in hospices. The findings show that healthcare assistants, who provide a large proportion of patient 'hands on care', would particularly benefit from additional training to incorporate rehabilitative palliative care into their practice.