Background A common problem in palliative care is that of a dry and sore oral environment often resulting in infections, bad breath (halitosis), and changes in taste, therefore high quality mouth care is a very important aspect of palliative care in all care settings. When these problems are not managed effectively, they can negatively affect a patient’s self-esteem, ability to communicate and socialise plus the ability to enjoy food and drinks (resulting in inadequate nutrition/hydration). It is vital therefore that mouth problems should be assessed regularly and treated as soon as possible (Marie Curie. Mouthcare, see: mariecurie.org.uk/professionals/palliative-care-knowledge-zone/symptom-control/mouth-care/).

Aims The Mouth Care Matters programme (Health Education England, see: https://mouthcarematters.hee.nhs.uk/) was designed to help deliver better clinical outcomes by evidencing the importance of good mouth care and how this positively impacts on general health and quality of life.

Methods We piloted the original ‘(Mouthcare Matters) Assessment and Recording Form’ in the inpatient unit with the aim of providing a thorough method of assessing and addressing oral challenges experienced by our palliative/end-of-life patients (Venkatasalu, Murang, Ramasamy, et al., 2020). We then audited outcomes by publishing a scored staff feedback form to colleagues to measure effectiveness of the intervention and explore whether amendments to the tool could be implemented to make it more bespoke to our care setting (National Institute for Health and Care Excellence: Palliative care: oral. See: cks.nice.org.uk/topics/palliative-care-oral).

Results When feedback was submitted, qualitative evidence identified the need to amend the standard to truly fit the hospice model of care.

Conclusions We amended the template in the following ways:

• The addition of ‘saliva’ as an identifiable problem (Paine & Snider, 2020).

• Changed ‘weekly’ assessment to ‘daily’ to reflect the pace of change some of our patients experience.

• The original tool identified low, medium and high risks but there was no advice to prompt intervention so we added an ‘action checklist’ section to help direct care.

We launched this amended version in April 2021 and are due to audit results in September 2021.