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Programmes focussing on wellbeing and rehabilitation have been a powerful response to supporting those diagnosed with a long term condition. This project is unique in combining three organisations across a wide network, to work together in addressing the emerging gap in provision.Collaboration between three organisations presented interesting cultural differences. At the same time, this project was introducing a cultural shirt from a problem solving, paternalistic and compliance focus of care towards one of empowerment and self-determination. A Learning and development (L&D) programme was developed bespoke to the hospices and aimed to:Increase staff knowledge and understanding of Self-Management Support (SMS) and Health Behaviour Change (HBC);Explain why SMS and Health Behaviour Change are important to current and future work of the hospices and how they link to the holistic needs assessment;Provide staff with opportunities to develop skills and approaches, enabling a person-centred approach to day-to-day practice;Increase staff confidence and skills to support people to self-manage;50 delegates attended the programme and evaluation was achieved through a longitudinal questionnaire to measure shift in confidence and attitude. Semi structured interviews and evaluation sheets explored delegate’s qualitative thoughts about the training and further education needs.Results showed:The L&D programme was rated positivelyThere was a shift in professionals beliefs towards the positive benefits of SMS and HBCL&D provided new skills and confidence in using tools to facilitate SMS and HBC in clinical practiceA bespoke assessment tool was developed by the teamA patient reported outcome measure was agreed based on the Macmillan 9 outcomesThe L&D programme is now an integral part of the education provided within the hospices.

The aim of this project was to implement volunteer supported ‘Real Time’ reporting; which enables patient feedback regarding their service experience to be reviewed and acted upon as it is collected, during a patient experience, rather than collating retrospectively. The project was based on the ‘Listening Differently’ pilot carried out in 2014 by Help the Hospices and Marie Curie.Two hospices have worked collaboratively together with a volunteer work force to successfully implement this project at local level. The work was driven by a team of 11 volunteers, over seen by Governance and Quality Leads. Project set up was quick and simple and learning experiences were shared across sites. Following set up, the project was run by a dedicated volunteer team. Results have uncovered nuggets of information to build services and improve patient experience.Real time surveying has been shown to:-Be an acceptable form of survey to patients;empowered all patients to ‘have a voice’ and enabled changes such as:-Supported patient’s preference for a single roomIncreased understanding ofmedical staff e.g. providing additional attention to giving patients full involvementAdditional support devoted to breathing exercises for patientsSupporting patients in ‘protected meal times’.Attention to installingheadphones fordouble rooms produced an increase in patient response ratesfrom 24% to 69% in the IPU setting and 20% to 100% within outpatient servicesImproved the quality of feedback being gathered as patients talked freely to volunteersEnabled a quicker response by the hospicesto feedback therefore improving care instantly.As a result of these findings, Real Time has been rolled out at both hospices in inpatient and outpatient units.

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These data shows that small service developments can make a big impact on palliative patients and the opportunity to exercise can and should be made available to all patients.