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P-36 Start the conversation (STC) – a collaborative community approach to end-of-life discussions
  1. Christine Novelli
  1. Isabel Hospice, Welwyn Garden City, UK


Background Advance care planning (ACP) is increasingly recognised as an integral part of achieving excellence at the end of life, but death and dying are not easy conversations to have, and as such the reluctance to talk about these issues increases the likelihood that a person’s preferences will not be discussed or met (Byw Nawr, 2016). The Compassionate Communities Charter recognises that raising awareness and promoting palliative and end-of-life care needs to be part of all aspects of health and social care and not the sole responsibility of those providing the services, encouraging communities to support people and their families who are dying or living with loss.

An end of life task and finish group consisting of NHS providers, local hospice and County Council representatives was established to co-produce a simple yet effective solution.

Aims To reduce the barriers to advance care planning conversations by offering tools and opportunities to empower communities to drive the conversation amongst themselves and their health care providers.


  • Created a leaflet and poster suggesting topics to think about, and introduce ACP.

  • Developed an informative website - - launched in Dying Matters Week 2021.

  • Downloadable ACP template.

  • Host free two-hours STC workshops.

  • Run monthly death cafés.

  • Identify and train partners and community champions to promote and engage further.

Results to date 2000 leaflets and 200 posters distributed around target area; 60 participants at STC workshop; engaged four partners; 188 hits on the website.

‘I understand much more now about what and how things happen around death, and how to be better prepared in advance so that it’s easier for everyone.’

Conclusions Early results are showing increased interest in: end-of-life and advance care planning conversations, addressing taboos and expectations of death and dying, and engaging new partners.

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