A program designed to assist in keeping patients with a terminal diagnosis at home instead of in the hospital has reached its milestone of 600 patients.

Since June 2022, the Marie Curie Responsive Emergency Assessment and Community Team (REACT) virtual ward has collaborated with palliative medicine consultants at Bradford Royal Infirmary (BRI), part of Bradford Teaching Hospitals NHS Foundation Trust. The three-year pilot, funded by Social Finance UK, was initiated in response to data revealing that end-of-life patients spent an average of one month in the hospital during their final year. In the first year of the pilot, the team successfully reduced the average number of bed days from 38 to 17.

Each morning, palliative care consultants visit BRI’s A&E to identify potential candidates for the REACT service. With appropriate plans in place, patients can be discharged to the care of Marie Curie’s REACT team for 72 hours until mainstream services can take over.

Palliative Medicine Consultant, Dr Clare Rayment, said; “We know that for many patients with a terminal diagnosis, a hospital admission can be very upsetting and provide a poor experience for patients and their families.

“Often, in a crisis, the place people come to is A&E but research tells us that hospital might not be the best place for them. Under REACT, we are now able to offer an alternative to that and an alternative to hospital as the virtual ward enables people to return home with care being provided by our colleagues in Marie Curie and this has halved the number of days patients spend in hospital in the last year of their life.

“It’s a joint decision-making process with the patient about what matters most to them and what their priorities are, knowing that they’re not going to get better. We know that the majority of patients, at the end of their lives, would prefer to be cared for at home, rather than in hospital. REACT makes their wishes possible.”

The REACT service is being piloted over three years – from June 2022 to June 2025 – to see how well it can help patients receive the care they need in the comfort of their own home.

Marie Curie UK’s Chief Medical Officer, Dr Sarah Holmes, who is based at Bradford’s Leeds Road Hospice, stated; “We are delighted with how this innovative service has made a real difference so quickly.

“One of the reasons it was developed was in recognition of the unmet palliative care needs across Bradford. This has proven very much to be the case as many of those REACT has helped over the past year had previously been struggling to access appropriate care, for a variety of reasons.

This partnership has not only helped them receive quality, joined-up care tailored to their need, it is also reducing the time they’re spending in hospital, often including crisis visits to A&E.”

Patient, Michael Busfield, from Bradford, has COPD and has been cared for by the Marie Curie REACT team at home following an emergency admission to the BRI’s A&E department recently.

He said; “One minute I can be fine and talking normal, but the next I might be out of it and can’t breath.”

“It’s great. I am happy to be home again – I’m my own boss again.”

The REACT service is fully funded by the End-of-Life Care Integrator through a ‘social impact bond’ which lasts the duration of the pilot. The funding for the pilot is managed by Social Finance with social investment from Big Society Capital, Macmillan Cancer Support and the Commissioning Better Outcomes Fund.

This month, the Marie Curie REACT team started accepting direct referrals from community services and organisations such as Airedale’s Goldline.