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<h3>Background</h3> Harrogate locality has a population of approximately 160,000. It has a higher than average elderly population which is predicted to increase, with increasingly complex health and social care needs of people with multi-morbidity including dementia, frailty and other long term conditions. Approximately 1% of the population are in their last year of life (LYOL) yet many are not identified or known to palliative and end of life care services and therefore rely on acute services at times of crisis. <h3>Method</h3> • Improve identification of patients who may be in the LYOL An Electronic Search Tool has been developed to identify patients with a palliative condition who are not currently included on the Palliative Care Register. SPICT1 is being used amongst hospital clinicians to identify patients approaching LYOL. • Improve access to advance care planning (ACP) Band 6 Registered Nurses provide a dedicated ACP Service to support clinicians who may lack confidence or time to undertake ACP conversations. Decisions are recorded using the local EPaCSS2 solution. A paper copy of the ReSPECT3 plan and a ‘What matters most’ are provided to share with professionals unable to access EPaCCS. • Provide access to Goldline4, a 24/7 telephone service for patients who may be in the LYOL and their carers. <h3>Results</h3> Between July 2024 and June 2025: • Positive patient and carer experience • Increase in patients on the Palliative Care Register from 0.63% to 0.74% • 515 referrals to the ACP Service • 803 calls (48% out of hours) to Goldline with 95% remaining at home • 3957 hospital bed days saved (11 beds) • 87% patients who have accessed the service(s) die in the community <h3>Conclusions</h3> The combination of identification, advance care planning and 24/7 advice and support has been demonstrated to reduce unplanned admissions to hospital in the LYOL in Harrogate. <h3>References</h3> Supportive and Palliative Care Tool NHS England — North West Electronic Palliative Care Coordinating Systems (EPaCCS) ReSPECT | Resuscitation Council UK Goldline - Airedale NHS Foundation Trust