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<h3>Background</h3> Virtual wards offer patients renewed opportunities to receive healthcare in the comfort of their own homes and to offer safe alternatives to secondary care. Acute admissions to hospital increase in the last year of life. Most patients would prefer to die at home, but complex needs and available care options often restrict this. <h3>Method</h3> Retrospective case notes review of the first two years of service and qualitative patient experience data. All patients discussed at morning MDT which is led by the clinical lead (Advanced Practitioner) and includes community partners such as Marie Curie for night care. Caseload of 10 patients. Contact is planned dependent on patient need. Senior clinical oversight is provided by the community consultant. Medical doctors, advanced practitioners, nurse specialists and health care assistants deliver clinical contacts dependent on patient need. <h3>Results</h3> 747 referrals in first two years (March 2023 to March 2025). 82% for complex symptom management, 18% for personal care support. 11 (1.5%) admitted to acute hospital – all clinically appropriate. Referrals from community into hospice inpatient unit reduced by 70% during first year of virtual ward. Feedback from patients and families has been 100% positive and describe feeling supported and grateful for the peace of mind the service offers. We have encountered some challenges. Palliative care does not fit easily into national virtual ward model and a lack of understanding of the nature of palliative care from strategic partners. There is concern about ongoing funding. <h3>Conclusion</h3> Allowed more patients with complex needs to be cared for at home – bring hospice level care to patients’ home. Helped to prevent crisis situations were acute admission likely. Fill domiciliary care gap on short term basis. Increased collaborative working with local community and acute partners.