Palliative care must change, grow and mature in response to the growing number and complexity of needs of community patients. Such demands particularly challenge conventional delivery of day hospice. In response our hospice redesigned day service provision to modernise bespoke day facilities, appoint a day hospice sister and introduce several novel clinical interventions. Patient outcome measures were introduced and research projects undertaken.The aim of the study was to evaluate whether extended day hospice services could address more patient needs. Newly developed services were introduced in the period April 2015 – May 2016. Management and clinical key performance indicators were obtained for this period and compared with annual data from the previous year. Two facilitated focus groups were undertaken with the multidisciplinary team and with the management team to better understand the service developments and participant’s aspirations for day services.It was found that introducing five additional patient services – Blood transfusion clinic; Progressive Supranuclear Palsy support group; Motor Neurone Disease clinic; Multi System Atrophy support group and a Carers’ support group – led to a 27% increase in attendances. Staff, patients and their families were recruited to three research projects by three hospice staff as a core part of their role, and five staff contributed to qualitative studies or data collection. The qualitative data indicated that staff were pioneering the new well-coordinated services but were challenged by the time available to capture data. The management team had a vision for further expansion of sustainable services and innovative approaches of working in partnership with the local acute trust and community care providers.In conclusion, a diversification of day services offered to patients and carers can be facilitated with engaged managerial and professional staff without a significant increase in core workforce.

BackgroundCompassion can be defined as the sensitivity to distress of self and others with a commitment to try and do something about it and prevent it. Compassionate care can positively influence staff efficiency, communication and patient and staff satisfaction by promoting person centred care. A compassionate workforce is vitally important to ensure that innovative practice and quality improvements succeed in meeting the challenges of modern healthcare (West et al., 2017). West et al. (2017) identify that compassionate leadership enhances the intrinsic motivation of staff and reinforces their fundamental values. It has been recognised that compassion within the workforce also creates a sense of safety and also develops a sense of empowerment and support. A key component of delivering compassionate care is empathy. Cole-King and Gilbert (2011) identified that a personal quality that influences someone’s capacity for empathy is self-compassion.MethodsWith this in mind, the leadership team at the Marie Curie Hospice, West Midlands focussed their efforts upon how best the workforce could be supported to facilitate compassionate care. A scoping exercise was carried out to build upon existing areas of good practice such as clinical supervision, morning debrief sessions for the night staff and Schwartz Rounds, and to make them robust. A gap analysis revealed that there were additional practices and skills that staff could apply to help build up their levels of self-compassion. The hospice is now working towards a weekly mindfulness session for staff, a weekly lunch time walking group, three minute mindfulness sessions before the start of meetings and the introduction of compassion circles. The latter has been adopted by other the local service providers, with the vision of developing a compassionate caring community.

availability of smoothies! User reported outcomes show 93% feel their views are appreciated and want to attend again. The group now takes place on two sites and also includes inpatients, discharged patients and bereaved relatives. Wasn't that nice! The success of the Feedback Group has been due to consistent user steer, good inter-service teamwork, leadership and not being disheartened by initial small attendance (e.g. less than 10).

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