A ground-breaking palliative care programme in Bradford is showing how collaborative, community-based support can keep terminally ill patients out of hospital
CREDIT: This is an edited version of an article that originally appeared in NHS Confederation
An initiative between Marie Curie and Bradford Teaching Hospitals NHS Foundation Trust is showing how joined-up working, rapid intervention and targeted palliative care can significantly reduce hospital admissions for patients nearing the end of life. Launched in June 2022, the Responsive Emergency Assessment and Community Team (REACT) programme offers insights for practice managers seeking to improve coordination and patient experience in primary care.
The Challenge: Unmet Palliative Needs and Overuse of Hospitals
Bradford faced a sobering reality: patients spent significantly more time in hospital in the final months of life compared to other regions. Additionally, nearly 1,000 people a year were not accessing any form of palliative care. This placed pressure not only on acute hospital services but also left patients and families without adequate support at a vulnerable time.
The REACT programme, a three-year funded initiative, aims to improve quality of life, reduce hospital bed occupancy and enhance access to palliative care by deploying Marie Curie nurses into the community. These nurses provide short-term crisis care and help stabilise patients at home, offering medical and emotional support while coordinating with other services until longer-term care arrangements are in place.
Key to its success is the integration of REACT into the hospital’s emergency department. Palliative care clinicians assess patients daily, identifying those whose needs could be better met at home rather than through acute hospital care. Once identified, patients are transferred to a virtual ward under REACT’s care, reducing unnecessary admissions.
Impact on Patients, Hospitals and Community Care
The programme is delivering measurable benefits that hold relevance for primary care settings:
Enhanced Patient and Family Experience: Patients receive personalised, dignified care at home, improving both comfort and emotional wellbeing for them and their families.
Hospital Efficiency Gains: By reducing unnecessary admissions, the programme has increased hospital capacity and allowed staff to focus on patients with acute needs.
Better Collaboration: The programme exemplifies effective multi-agency working, involving GPs, district nurses, hospices and hospital staff in coordinated care planning.
Earlier Palliative Intervention: Embedding palliative clinicians in A&E led to earlier identification of palliative needs, a factor known to improve long-term outcomes.
While the REACT programme is hospital-initiated, its success offers valuable lessons for GP practices and primary care networks:
Opportunity for Earlier Identification: GP teams can adopt proactive identification strategies for patients who may benefit from palliative support, ensuring timely referrals.
Strengthening Multidisciplinary Collaboration: REACT highlights the benefits of seamless coordination between general practice, community services, and specialist care teams.
Preventing Crisis Admissions: With the right crisis response support and early planning, patients can be managed effectively in the community – reducing distress for families and preventing avoidable hospital use.
Embedding Person-Centred Approaches: The personalised care REACT provides reinforces the importance of holistic planning, something that can begin in primary care consultations.
As general practice continues to face growing demands, this case study offers a powerful reminder that well-coordinated, patient-first care is not only possible – it’s essential. For practice managers, supporting staff to recognise palliative needs early, fostering strong links with local hospices and community services, and advocating for community-based crisis care models can be transformative for both patients and systems.
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