Background The Outcome Assessment and Complexity Collaborative (OACC) is a suite of measures designed to assess patient related clinical outcomes. It now guides service development of virtually all palliative care services in the UK. Pilgrims Hospices in East Kent, implemented three of the six OACC measures of in 2016 (AKPS, POI, IPOS). However, there has been limited training since and further development hampered by the geographical challenges of the service. The hospice were keen to support their clinical strategy with clearly defined targets and clinical outcomes, promoting service and staff development. The employment of a new Consultant led to a review of current practices around OACC which identified shortcomings.

Methods A ‘Task and Finish’ group agreed an implementation program with new Key Performance Indicators to demonstrate clear outcomes, reflecting the clinical work, and caseload complexity. Standard Operating procedures were agreed. Consultant-led Mandatory training for all clinical staff was provided and extended to administrative staff and the Board of Trustees.

All six OACC measures were introduced.

Enthusiastic individuals formed the ‘Group of OACC Champions’ providing a ‘bottom up’ approach. A brooch on their work uniform allows easy identification. This group meets regularly to reflect on the agreed standards; discuss outcome reports and how to share them; and decide how to develop OACC further.

Results Early reports have shown an increased uptake of OACC measures (admission IPOS up from 78% to 92.2% between 2021–22), better understanding of the measures and the ability to demonstrate positive patient outcomes as the result of hospice input.

Conclusion This project shows how an organisation can redefine their clinical strategy over ten months. Support from senior leads with a clear and shared vision is vital to allow a bottom up approach by the workforce. An inclusive and constructive approach is vital which should be led by interested individuals.