Background The End of Life (EoL) Strategy (2008) recommends a care pathway approach for commissioning and delivering integrated EoL health and social care (H&SC) services. The historical development and redesign of services within a large healthcare economy in the North West of England led to varying standards of EoL care provided by two primary care trusts, two local authorities, one acute hospital trust, one integrated Specialist Palliative Care Team and one out-of-hours service. With the proposed changes to commissioning and service provision, along with the current economic climate, the structure of services was again under redesign. This provided an opportunity to influence the strategic and operational direction of EoL services within the locality.

Aim To set up an EoL Group for the H&SC economy.

Method In order to facilitate partnership working, a small EoL operational group including key representatives from all the local stakeholder organisations was established. This group quickly demonstrated achievements in: • EoL care pathway design • Cross-organisational production of collaborative EoL guidance and documentation • Improving coordination and communication systems • Novel education and teaching initiatives This group was invited to put forward their vision, strategy and priorities for EoL care to the overarching H&SC Board for the locality.

Results The vision and strategic priorities for the new EoL Group will be presented in detail, along with the action plan to facilitate seamless EoL care across the H&SC economy. Facilitating factors, barriers and key points learnt during the process will also be discussed.

Conclusion The ability of a small number of dynamic individuals to influence and direct the strategic structure of EoL care for a whole locality is demonstrated. The driving force behind this exciting opportunity was the focus, enthusiasm and commitment of every member to work together collaboratively to enable high quality EoL care for all.