Improving experiences for people at end of life through social investment
Author
It’s a simple idea — but it works.
In Hillingdon, a North London borough, one phone line connecting people to a 24 hour palliative care support service has helped reduce the number of days people spend in hospital at the end of life — and given patients and families more control when they need it most.
But for the Your Life Line project to succeed, everyone involved needed space and time to think differently.
And that’s where we came in.
Without Social Finance, we wouldn’t have achieved what we did—at least not on the same scale or timeframe. Their belief in us, their knowledge of the system, and their willingness to stick with us made the difference.
Liz Bunker, Lead Nurse for Palliative Care, The Hillingdon Hospitals NHS Foundation Trust
The service
Your Life Line was designed to address a critical gap in existing palliative and end-of-life care services in the Borough. It combines two key elements:
- A Single Point of Access (SPA) for advice, triage and coordination.
- A Palliative Care Overnight Nursing Service (PONS) to offer fast in-person clinical support when needed.
What sets this model apart is its flexibility, responsiveness, and person-centred ethos. Calls are handled by practitioners who can triage or escalate appropriately .
Taken from the Your Life Line webpage.
“The Your Life Line Team is here to help coordinate your care if you (or your carer) are in need of advice, support or nursing care.
We will discuss your care over the telephone with you or your family member or carer and plan with you how to best to support you.
Depending on the help you need, we can either give you support over the telephone or arrange for someone to visit you at home.
The number is free to call, although there may be a charge with some mobile phone providers, so please ask if you need us to ring you back.
The team is made up of clinical nurse specialists who care for patients with complex needs in the last weeks and months of their life (with any diagnosis). Working in partnership with the Hillingdon district nursing teams (who deliver nursing care in the community) and other organisations, the team works to:
- Help and support you to remain in your own home
- Prevent avoidable admissions to hospital
- Respond to your choice of preferred place at the end of your life.
The service is open 24 hours a day, 7 days a week, 365 days a year.”
The funding model
The Your Life Line project was financed for a period of 3 years starting in September 2018, using a Social Impact Bond (now known as a Social Outcomes Contract or Partnership).
The £900,000 investment into the service was made by the Care & Wellbeing Fund, a £12 million pound fund set up and overseen by Social Finance.
Social Finance also provided critical support throughout the investment period, including helping to design the service so it met local needs, bringing all parties together to agree measurable outcomes, and providing technical expertise to ensure data was gathered and analysed appropriately so outcomes payments could be made.
The partners
- Hillingdon Clinical Commissioning Group* (Now the North West London Integrated Care Board) commissioned the service and made payments back to the fund based on outcomes achieved.
- Central and North West London NHS Foundation Trust delivered the service.
- Hillingdon Health and Care Partners (HHCP), a coalition of hospital services, GPs and community and voluntary services, including Harlington Hospice and Hillingdon Carers, made referrals to the service.
* As with all other CCGs, this was disbanded when the Health and Care Act 2022 replaced them with Integrated Care Boards.
Evidence of impact over 3 years*
* 1st September 2018 – 31st August 2021.
Sustaining the service
When the social investment ended in 2021 the local clinical commissioning group (the outcomes payer) decided to directly fund Your Life Line. We have identified three factors critical to its success:
- Early commissioner engagement – Hillingdon Clinical Commissioning Group* now the North West London Integrated Care Board was involved from the beginning
- System-wide support – GPs, hospital teams, and ambulance services all advocated for the service
- Adaptability under pressure – Particularly during Covid-19, where the service proved vital in keeping people out of hospital
What role did Social Finance play?
Having never previously worked with an organisation like Social Finance, I was sceptical, but without question, the support understanding and help that has been given has been outstanding. All staff who have engaged with us have shown a clear understanding of the vision that we had and also understood the local landscape.
Steve Barnes, Hillingdon Health and Care Partners
In Hillingdon, services were fragmented—community, hospice, and acute care often operated in silos. Social Finance acted as a neutral convenor, drawing partners into a shared space with common language, goals, and trust.
The result? A genuinely integrated service that continues to function as a single point of access—not just in name, but in day-to-day practice.
Social Finance provided practical and strategic input from the start: running co-design workshops, modelling the service and funding mechanisms, and helping the local team navigate a complex commissioning landscape.
In a health system used to ‘survival mode’, Social Finance gave clinicians the headspace to reflect, design and iterate. This was key to moving beyond sticking plaster solutions and building something meaningful.
The relationship didn’t end with the investment. Clinicians and managers in Hillingdon continue to collaborate with Social Finance—sharing learning, mentoring other sites, and supporting the next phase of innovation.
We now have a functioning Single Point of Access that without Social Finance would, in my opinion, not have been achieved either from a financial or timing perspective.
Liz Bunker, Lead Nurse for Palliative Care, The Hillingdon Hospitals NHS Foundation Trust
What have we learned?
- Keep it simple. One phone number, one team, one system-wide commitment.
- Start small, grow with purpose. Begin with the last three months of life. Expand once stable.
- Don’tunderestimate emotional impact. A rapid response service changes not just outcomes, but the experience of dying—for patients, families, and staff.
- Legacy matters. Since launching in 2018, Your Life Line remains a beacon for how health and care can work together differently.
Get in touch
If you’d like to find out more about social investment in health and social care, including our latest innovation, the Neighbourhood Transformation Fund please email us on or click on the contact button below.
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