Developing international evidence suggests that cultural norms and ethical principles of a family, population or healthcare environment influence attitudes towards CAH, particularly where CAH has symbolic meaning; representing care, hope and trust. However, there is surprisingly little robust evidence regarding dying patients, or the wider general public's views, on the perceived value of CAH in the last days and hours of life. Accordingly, a need for greater understanding of the perceptions regarding CAH, and their effects, is required.

Background Although the value of hospice volunteers is widely recognised, their role within the hospital setting is less established. An end-of-life volunteer companionship programme was established within an UK hospital to help support dying patients and their families ( provision of 'sitting' service and psychological support). Aim To assess the effectiveness of a two-day volunteer training programme. Methods Fifteen hospital volunteers were recruited due to length and experience of service; a further two through personal expressions of interest. A questionnaire (assessing knowledge, confidence about communication and support skills) was given: pre-training; 2 weeks post-training; and 3 months posttraining. Each question (n=17) had 5-point Likert-scale response options (1=strongly disagree, 5=strongly agree). Free text response boxes were provided.Two further cohorts of volunteers have been recruited (total n=30) and additional results are forth-coming. Results From the initial 17 volunteers, 14 were female with ages ranging from 19-70 years. Statistically significant improvements were seen across all knowledge scores post-training and were sustained after 3 months.