Project information

The Royal Marsden’s Palliative Care –Hospital2Home

Most terminally ill patients wish to receive end of life care at home or in a hospice rather than in a hospital. We will provide patients with the widest possibility of choice by funding the continuation of our Hospital2Home project, which improves facilities & local support networks to enable this.

January 2011 - January 2014

Charity information: The Royal Marsden Cancer Charity

The Royal Marsden Cancer Charity logo
  • Need


    The Department of Health’s End of Life Care Strategy research shows that most terminally ill cancer patients would prefer to die at home, yet due to a lack of confidence in or understanding of local support networks & services available, nationally only 18% are actually able to achieve this.

    The emphasis must, therefore, be on end of life care planning that empowers generalists & community staff to provide high quality home care right up until the final stages of life.


    The Royal Marsden has piloted a unique ‘Hospital2Home’ (H2H) service to provide choice & co-coordinated care for patients leaving hospital to die at home.
    H2H seeks to strengthen the links between our two hospitals & patients’ homes by strengthening the coordination of local services to assist people to receive end of life home care. The service was developed & is led by our palliative care lead consultant, Dr Julia Riley, in line with Professor Lord Ara Darzi's end of life care work stream.

  • Aims

    Aim 1

    Provide peace of mind for patients & families by helping them to receive care where they wish


    » When a patient enters the scheme a case conference is organised in their home within 72 hours of leaving hospital.
    » This is attended by the patient, their carer, GP, district nurse, community palliative care nurse & an H2H Clinical Nurse Specialist.
    » Social & spiritual workers may also be invited to attend.
    » A care plan is agreed & an appropriate healthcare practitioner allocated responsibility for each item outlined within the case conference.

    The project has already enabled 78% of all patients entering the programme to receive end of life care in their preferred location, compared to the national average of 18%.

    Aim 2

    Centralise information to ensure integrated patient records & the maintenance of support networks


    » The patient’s care plan, medications, preferred place of care & death & other details are documented in a new electronic End of Life Care record.
    » This electronic record centralises information & allows remote access to the patient & all relevant healthcare practitioners.
    » The patient's listing on the record is also illuminated to the ambulance service if they receive a call from their address, so they know their wishes.
    » The Royal Marsden is currently the only organisation to use this electronic iniative.

    If successful, within the next three years we hope for even more patients to be receiving end of life care in their preferred location due to improved support networks.

    Aim 3

    Ensure collaborative working between the Hospital, local healthcare providers & community groups


    » An H2H service brochure has been sent to local general practices & community healthcare providers to ensure integrated working across all parties.
    » The brochure is also available in each of The Royal Marsden Hospitals, in Sutton & in Chelsea.

    If successful, within the next three years we hope for even more patients to be receiving end of life care in their preferred location due to improved support networks.

    Aim 4

    Transform national communication networks


    » The End of Life Care record will be part of the overall London roll out, helping to join acute & primary care closer by improving detail transfer.

    The NHS is keen to follow The Royal Marsden’s pioneering example. The national adoption of this by the NHS across all networks will be a huge mark of success for the programme.

    Aim 5

    Share knowledge & skills


    » This has received a great deal of interest both locally in the Sutton & Merton regions & nationally by the NHS, which is keen to follow our example.
    » We will also produce a DVD to train other palliative care specialists.

    The NHS is keen to follow The Royal Marsden’s pioneering example. The national adoption of this by the NHS across all networks will be a huge mark of success for the programme.

  • Impact


    The Hospital2Home project works to reshape the future of palliative care & patient choice, integrating local services for lasting relationships between community health providers & hospitals & allowing more people to end their lives in their chosen location. The NHS hopes to model its future development of palliative care upon it.


    There could be difficulties in coordinating local services & community health care providers. These will be minimized through the End of Life Care record, which provides an online recording system for all parties, & through ensuring that Hospital2Home responds to needs highlighted in the Department of Health’s End of Life Care Strategy.


    Donors to this project will receive reports from the fundraising & Palliative Care teams. The project’s development will also be documented in the charity’s newsletters & Annual Review.

  • Budget

    Budget - Project Cost: £551,000

    Loading graph....
      Amount Heading Description
      £551,000 Hospital2 Home Scheme Enable patients to receive end of life care in the location of their choice

    Current Funding / Pledges

    Source Amount
    Charitable Donations £50,000 Guaranteed
  • Background


    The Royal Marsden opened in 1851 as the world’s first hospital dedicated to cancer treatment & research. At our sites in London & Sutton, Surrey, we see more than 40,000 patients a year. Most come from London & South East England, but we also receive referrals from across the UK & abroad.

    The Hospital2Home project supports patients across both sites & works with local general practices & healthcare providers.


    The Hospital2Home scheme benefits palliative care patients across both hospital sites, & is the pilot for an eventual nationwide roll-out by the NHS.

  • Why Us?

    Why Us?

    The Royal Marsden Cancer Campaign is The Royal Marsden’s charity. The Hospital has provided inpatient palliative care since the 1970s & is the UK’s largest hospital palliative support practice.
    The scheme was created by our Consultant in Palliative Medicine, Dr Julia Riley, who is also Chair of the Supportive & Palliative Care Group South West London & advisor to the Care Quality Commission & sits on the Department of Health’s review for a national currency & pricing plan for palliative care.

    Read more about the Charity running this project.


    Dr Julia Riley, Consultant In Palliative Care At The Royal Marsden

    Success will be through Dr Riley 's leadership & the relationship between patients, carers, GPs, district nurses & H2H Clinical Nurse Specialists.

We will provide better facilities and choices for patients towards the end of their lives to help them fulfil their wish to be cared for at home.

Dr Julia Riley, Consultant in Palliative Medicine at The Royal Marsden Hospital