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.

BackgroundA number of studies have established the benefit of exercise as part of a palliative care programme (Van den Dungen et al., 2014; Salakari et al., 2015; Malcolm et al., 2016; Paltiel et al., 2009), however, there are still research questions to answer about the effects of group exercise interventions.AimTo assess the impact on the patients’ physical and psychosocial wellbeing of an eight week group exercise programme with individualised goals.MethodsWe conducted a quantitative and qualitative analysis on data collected from the 19 adult patients included in the study (17 cancer diagnosis, 1 pulmonary fibrosis, 1 neurodegenerative condition). Inclusion criteria: patient willing to participate in a group exercise programme and able to complete the baseline assessment (6 min walk test, Timed up and go, Berg balance scale, EORTC QLQ-C30, HADS, open text questions about their experience of undertaking the intervention).ResultsData suggest an improvement in physical function and minimal changes in psychological function. Returned questionnaires advise that peer and professional support, investment in the patient‘s goals and a general openness to share and discuss experiences seem to be key elements in the observed positive reframing of the experience of illness and present and future deterioration. We observed increased sense of control, social participation and enjoyment of life.ConclusionsDespite limitations (small sample, no control group), we were able to explore how personalised exercises in a small group can foster patients‘ resilience possibly through the reappraisal of their condition (Monroe & Oliviere, 2007) and a reconnection with their own body and experience (Morgan et al., 2017). Interestingly, it was not always straightforward to link data with what was observed clinically and reported by patients e.g., deterioration in tests but improvement in function and general wellbeing. From what was observed, a group exercise intervention in palliative care seems feasible, cost-effective and valid in improving physical and psychosocial wellbeing in the population studied. A control group is to be considered to deepen the analysis.