Background Effective clinical supervision benefits patient care?by:

• Enabling staff to challenge practice in a confidential environment and reflect on feedback separate from managerial considerations

• Enhancing staff wellbeing through enabling exploration and management of both the personal and professional demands created by the nature of their work in palliative care.

Aims To introduce multi-disciplinary reflective practice groups (MRPGs) into three children’s hospice services.

Method Ninety-minutes sessions followed a structured nine-step process, led by an experienced facilitator. Groups had open membership, ran with 4–10 participants and there was mandatory minimum attendance. Group membership included care assistants, nurses, counsellors, art and music therapists and play specialists but excluded care managers. Participants brought a clinical work related dilemma to share, with one dilemma being chosen and discussed throughout the session.

Post every session, participants rated the reflection and identified learning by giving an example of “One thing I am going to take away from today’s session is…”

Results Between November 2015 and April 2016, 31 MRPGs took place, with 156 participants, totalling 106 different staff.

90% of responses agreed or strongly agreed that MRPGs were useful, with positive response rate increasing over the six month period.

In eight out of 31 groups, >75% of participants strongly agreed that MRPGs were useful. All eight of these groups discussed a clinical nursing related dilemma rather than a psychosocial focussed issue. Key themes in analysis included ‘normalising and validating’; ‘improving practice/skills in work with families’; ‘reflection’ and ‘taking action’.

Conclusions Contrary to staff expectations MRPGs were perceived useful by staff themselves. Key learning areas reported were a good fit with background reasons for introducing the sessions. Our next steps are to:

• Collect examples of perceived impact on the quality of clinical work with children and families across the different disciplines

• Widen participation to include bank staff, volunteers and hospice employees not providing direct clinical work.