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IntroductionIt is evident that people from minority ethnic groups are under-represented amongst palliative care service users, despite a national (UK) strategy promoting high quality palliative care for all adults at the end of life. Audit data showed the percentage of people from minority ethnic groups accessing the hospice was only 1.46%, versus a national average of 7% accessing specialist palliative care services. This was particularly concerning given the ethnically diverse population in one of the CCG areas served by the hospice.AimTo increase the use of hospice services by people from ethnic minority groups.MethodsA cross organisational working group was established, chaired by a clinical director, with representatives from the medical, nursing, pastoral care, therapies and fundraising teams. During sequential workshops between May and September 2014, the group devised and implemented a multi-pronged action plan to improve the ethnic diversity of patients and carers accessing hospice services.Engagement of community faith leaders as hospice ambassadors: introduced leaders to newly built spiritual area (“The Sanctuary”); offered to host meetings of the local clergy at the hospice; faith leaders participated in spirituality education sessions for hospice staff; modelled synergistic working relationships between hospice pastoral care team and external faith leadersEngagement of primary care clinicians in under-represented geographical area: increased hospice consultant presence at primary care end-of-life register meetings, promotion of palliative care services at primary care academic half dayReview of hospice marketing literature and physical environmentResultsImprovement in the percentage of people from minority ethnic groups using hospice services, from 1.46% in May 2014 to 10.84% by September 2014.ConclusionWith a cross organisational approach, it is possible to improve the ethnic diversity of hospice service users. This however requires ongoing monitoring through audit, and assessment of patient and carer satisfaction.

et al., 2011), representing potentially widespread unmet educational needs. Aims Following several drug incidents at our hospice, we aimed to design an educational intervention to facilitate sustained learning of opioid conversion skills. It was intended to be resource-efficient to administer and transferable to community, hospice and hospital settings. The initial target audience was registered nurses (RNs) and junior doctors at a single hospice. Methods Fifteen clinically relevant questions were formulated to assess baseline ability in opioid dose conversion, calculation of appropriate breakthrough requirements and background dose amendment. A symmetrical final assessment was written using different dose integers. A workbook was written to constructively align with the assessments and evolved following small pilots, incorporating feedback. After a didactic introduction, each section included a calculation example and five selfmarked practice questions (41 in total), with increasing complexity. Participants attempted the 32-page workbook after sitting the baseline assessment and before completing the final assessment. Interval reassessment was undertaken to evaluate learning durability. Results 39 hospice staff have completed the programme to date (26 RNs, 13 doctors). The overall mean baseline test score was 3.3/15 (range 0/15 -10/15, RN mean 2.8/15, doctor mean 4.2/15). After completion of the workbook, 38 of 39 participants scored 15/15 (mean 14.6/15). The mean score at interval reassessment of 14 RNs (mean six months after workbook completion) was 14.8/15 (range 14/15 -15/15). Opioid-related patient safety incidents also decreased following workbook introduction. Conclusions The workbook is an effective educational intervention that significantly improves opioid conversion ability and is sustained six months after completing the training. We plan to introduce the evolving workbook at a local hospital and seven other hospice sites over the next eight months.