Where people die is changing: early activity of a dedicated nurse-led end-of-life care ward in an acute hospital

Introduction
Most in-hospital deaths occur on acute wards designed for cure, not comfort. In April 2026 our trust opened an 18-bed nurse-led end-of-life care ward in a quiet building apart from the acute site, with individual bays, a walled garden, daily specialist palliative care input and open visiting. Two referral pathways operate: patients in the last days of life, and fast-track discharge to preferred place of care. We report activity from the first eleven weeks.

Methods
Service evaluation using routinely collected data (14 April to 28 June 2026). Ward deaths, trust-wide deaths and discharge destinations were summarised descriptively and compared with historical trust-wide patterns.

Results
Forty-nine patients died on the ward in its first 49 days (approximately one death per day; 57% day, 43% night). By late June the ward accounted for a mean of 32% of all in-hospital deaths, and up to 44% of non-critical-care deaths in some weeks. Trust-wide weekly and monthly death counts remained within historical ranges, indicating redistribution of where people die rather than additional mortality. The largest referring specialties were geriatric medicine (29%), stroke medicine (22%) and general medicine (10%). Approximately twenty fast-track discharges were achieved in the first weeks: 55% to home or usual residence and 40% to a care home. More than fifty nurses applied for the six specialist posts.

Conclusions
Within one quarter, a nurse-led ward with specialist input became the place of death for around a third of hospital decedents, without altering total mortality. Findings are descriptive and early, but suggest a dedicated ward model can rapidly relocate dying from acute wards to a purpose-designed environment.