RT Journal Article SR Electronic T1 The impact of and response to the COVID-19 pandemic on a hospital palliative care team JF Future Healthcare Journal JO Future Healthc J FD Royal College of Physicians SP 62 OP 64 DO 10.7861/fhj.2020-0131 VO 8 IS 1 A1 Polly M Edmonds A1 Katherine E Sleeman A1 Natasha Lovell A1 Rosemary Chester A1 Richard P Towers A1 Stephen A Marshall A1 Irene J Higginson A1 Sabrina Bajwah A1 Wendy Prentice YR 2021 UL http://www.rcpjournals.org/content/8/1/62.abstract AB London was at the forefront of the COVID-19 pandemic in the UK, with an exponential rise in hospital admissions from March 2020. This case study appraises the impact on and response of a hospital palliative care service based in a large inner-city teaching hospital. Referrals increased from a mean of 39 to 75 per week; deaths from 13 to 52 per week. Multiple actions were taken by the team to manage the surge in referrals, which have been categorised based on the 4S model: systems, space, stuff and staff. Several lessons are highlighted: need for flexible and responsive staffing over the 7-day week; implementing clear, accessible clinical guidance supported by ward-based teaching; benefits of integrating clinical practice with research; and the importance of maintaining team well-being and camaraderie to sustain change. Further evaluation is needed of the differential impact of changes made to inform service planning for future pandemics.