Background A hospice collaborative exists at the CEO level between Mountbatten, Oakhaven, and Rowans Hospices. Although historically staff joined hospices with palliative care experience, as vacancy levels have risen a more diverse workforce has been recruited with little or no palliative care experience. Our collaborative started to discuss the HEE Advanced Practice Framework, and how this relates to palliative and end of life care workforce development.

Aims To harmonise staff development across the collaborative and establish uniform standards of palliative and end-of-life care. Ensuring staff moving across the hospices have the same level of proficiencies, building upon succession planning and a skilled workforce into the future with enhanced and advanced level skills.

Method Competencies from across the collaborative of hospices were shared and then mapped against the NMC standards of proficiencies for Specialist Practitioner Qualifications. These were further mapped across the HEE framework of the four pillars of advanced practice enabling staff to review individual levels of proficiency achieved and focus their career aspirations. We have purposely called these proficiencies as they sit across Band 5–7 skills and apply to Allied health Professionals and Registered General Nurses equally.

Results The number of staff now completing proficiencies up to non-medical prescribing has increased by 34%, supporting system pressures and resulting in better symptom control for patients delivered in their own homes by staff with enhanced skills to undertake this autonomous practice. Staff retention has also improved.

Conclusion In the current financial climate access to clinical professional development funding for non-NHS staff is challenging. We have used our limited financial resource utilising the skills of the current specialist workforce to develop the enhanced skills needed for our clinicians new to palliative and end-of-life care. Building stronger resilient clinicians with the enhanced and advanced skills to deliver complex palliative and end-of-life care.