BackgroundProviding care for our patients during the COVID-19 pandemic required a rapid shift to video consultations (VCs). A service evaluation was performed to capture hospice professionals’ (HPs) and patients’ experiences of VC.MethodsOnline or postal surveys were sent to HPs and patients, who had participated in VC between March and July 2020, focusing on their experience and satisfaction with the service.Results31 responses from HPs were received. 19 (61.3%) rated their experience of VC as good, despite 29 (93.5%) having no prior VC experience. One-third of HPs had undertaken potentially sensitive consultations, including resuscitation discussions. 23 (74.2%) undertook a VC that included a family member and 18 (58.1%) had included an external healthcare professional. 25 (80.6%) wanted to offer VC as an option going forward. Well-being staff successfully provided multiple group support sessions via video. 26 responses from patients (23) and carers (3) were received. 22 (84.6%) had access to a smartphone. 8 (30.8%) included a family member in their consultation. All patients/carers reported satisfaction with their VC, although 10 (38.5%) expressed a preference for face-to-face consultations. 22 (84.6%) patients would be happy to receive care via VC going forward and 21 (80.8%) stated they would recommend the use of VC to others.ConclusionPatients reported VC to be an acceptable way to receive support from a hospice service and HPs would like to continue to offer VC in the future. VC can be offered as an alternative to face-to-face consultations with the potential to continue and improve access to a wide range of hospice services.

Findings suggest that the European Certificate in Essential Palliative Care improves confidence in palliative care and that this is sustained over time with evidence of confidence in symptom control, communication and a holistic approach in clinical practice.

The UK charity, Macmillan Cancer Relief, commissioned a 3-year pilot project employing 12 GP clinical facilitators (GPCFs). The aim was to raise the standard of generalist palliative care, provide extended clinical palliative care and provide a coordinated framework for commissioning specialist palliative and cancer care in Powys, rural Wales. As part of the comprehensive evaluation, surveys of GPCFs, GPs, district nurses and community hospital nurses were undertaken in order to record changes in palliative care activity, specialist palliative care services and training needs. Services providing 24-hour nursing and social services were perceived as in need of development. Referrals to Macmillan nurses increased by 40% and GPs reported that time spent on palliative care increased, on average, from a quarter of a day to half a day per week, although district nurses reported a reduction in palliative care activity. The majority of nurses thought that the GPCF's contribution was important. The use of local palliative care guidelines increased significantly among district nurses by the end of the project.

Background Hospices seek to improve end-of-life care by providing a number of different services to patients, their families and the wider community. However, few hospices appear to openly challenge themselves by asking -Did we make a difference? If yes, how so? If not, why not? (New Philanthropy Capital, 2020). An Impact Framework is a measurement framework by which an organisation can assess and demonstrate how successfully they are influencing change and achieve more for the people they serve. Aim The aim of this project was to devise an Impact Framework (NHS England. 2020) which would allow three key departments (Clinical, Community Engagement and Education & Research) to demonstrate the impact of our service in a way which is meaningful to different audiences. Methods Leads of three key departments and a marketing and communication specialist formed an Action Learning Group to support each other in devising three parallel and complementary ways to demonstrate their impact. They did this by:. Sharing data.. Identifying gaps.. Identifying challenges in data collection.. Devising innovative ways to capture data.. Planning where and when data would be reviewed and analysed. . Identifying how, when and to whom learning would be communicated.

underpinned the narratives. Nurses struggled with not being able to care for patients and their families in a way that they were used to and that felt intuitive and many described personal as well as professional affront. Conclusions Restrictions had a considerable impact on palliative care nurses at a professional and personal level in their ability to communicate with and provide care for patients and their families which led to moral distress and injury. How they managed this and made sense of what happened affected their capacity to cope, with those unable to reconcile their experiences being profoundly impacted and losing hope for the future.