{'fraction_non_alphanumeric': 0.02746294681778553, 'fraction_numerical': 0.06190061028770706, 'mean_word_length': 4.3125, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
21 The effect of the COVID 19 pandemic on referrals and deaths at meadow house hospice (MHH)

Background COVID 19 has caused untold levels of suffering throughout the world. Palliative care is essential, however access may be limited due to demand (Radbruch, et al., 2020). Services have had to respond with flexibility and rapid changes to systems and policies (Etkind, et al., 2020). In light of this we looked at data on referrals to see the impact that COVID 19 has had at MHH. Methods We compared data on referrals and deaths from January to June 2020 with data from previous years. Results Referrals to Meadow House hospice were steady during the first half of 2020 compared to previous years, with 1095 referrals from January - June 2020 compared to 1934 from January - December 2019. There were more community referrals with 970 referrals from January - June compared to 1618 in the whole of 2019. Lymphoedema referrals in contrast were reduced with 57 referrals from January - June 2020 compared to 170 from January - December 2019. There was a peak of referrals in April with 186 referrals in 2020 compared to 119 referrals in April 2019. There were 723 deaths between January - June 2020, compared to 1037 from January - December 2019. This predicts a higher overall number of deaths in 2020. The peak number of deaths was in April 2020 with 185 deaths compared to 90 deaths in April 2019. In April 2020 COVID accounted for 18% of deaths. The majority of COVID deaths occurred in the inpatient unit. Conclusion This analysis has revealed that in the context of a second wave there may be increased community referrals and reduced referrals to additional services like lymphedema. Resources may need to be redeployed to where need is greatest. There were increased deaths during the peak of the pandemic, and most occurred in the inpatient unit. This may impact on bereavement services in the future. References Etkind S. et al, 2020. The role and response of palliative care and hospice services in epidemics and pandemics: a rapid review to inform practice during the COVID-19 pandemic. Journal of Pain and Symptom Management, 6(1), pp. e31 – e40. Radbruch, L. et al, 2020. The key role of palliative care in response to the COVID-19 tsunami of suffering. The Lancet pp 1467 – 1469.