Background/context The Hospice in North Hampshire had offered support and care to MND patients but in an unstructured way. Close working between the Palliative Medicine and Neurology Consultants led to a recognition that both early and advanced care could be improved if services were to work more closely together. Aim The aim was to set up and run a montly multi-disciplinary clinic for people with MND in the Hospice, allowing access to all members of the multi-disciplinary team (neurologist, consultant in palliative medicine, care centre co-ordinator, hospice at home team, social worker, physiotherapist, OT, speech and language therapist, Association Visitors) via one clinic. The clinic link with the MNDA would improve access to information about services. The outpatient hospice setting allows informal support for pts and carers from Assoc Visitors. Outcomes To improve the patient and carer experience. To ensure access to hospice services early in diagnosis. To improve both peer and carer support through joint working with the MNDA. To develop a specialist skill base with opportunities for support and training of other professionals. To develop patient professional relationships which allow easy transition in the end stages of illness. Application to hospice practice Many centres across the country run a multidisciplinary MND clinic but traditionally in the hospital settling. Evidence is good for improvement in patient care from a hospital model of service delivery model. Hospices have many advantages with their experience in coordinating care and community focus. The early links with the Hospice allow continuity of care throughout the patient journey.

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1. To investigate the documentation of code status discussion on admission to hospital. 2. To investigate patient outcomes in those referred to Palliative care services.

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