Background Palliative patients often feel isolated due to the lack of discussion on sex and intimacy during their health journey. Healthcare professionals also avoid these conversations, contributing to the problem (Care Quality Commission. Relationships and sexuality in adult social care services; Guidance for CQC inspection staff and registered adult social care providers. 2019; Marie Curie. ‘Hiding who I am’: The reality of end-of-life care for LGBT people. 2016). A culture of avoidance among staff became evident for a variety of reasons, fear of saying the wrong thing and ‘it’s not my role’. This was mirrored by patients and carers, who felt unable to start the conversation with their healthcare professionals.

Aims To empower teams to facilitate open conversations. To introduce cuddle beds for patient use.

Methods July 2023. Established a task group, analysed staff using a questionnaire to identify training needs, planned for engagement and future funding of a ‘cuddle bed’. Cuddle beds support two or more people to be physically close and lay together, deepening connection and providing comfort. Cuddle beds offer patients and loved ones a compassionate approach to end-of-life care. The physical presence of one in the building acts as an invitation to enable open discussions on sex and intimacy.

February 2024. Awareness week held, distributed conversation starter cards, displayed the cuddle bed publicly, and ran a social media campaign. Hospice outcome measure modified to include the question about the impact of illness on intimacy and sex in relationships.

March 2024. Trained nine senior clinicians in advanced communication skills related to sex and intimacy.

Results Positive feedback both quantitatively and qualitatively. Two cuddle beds fully funded by bereaved relatives due to campaign. Staff survey showed an increase in competence and confidence in supporting those conversations.

Conclusions Feedback from patients, partners, and staff indicates increased confidence and competence, enabling a holistic patient-centred approach.

Continuing work: Audit of feedback of hospice outcome measure. Teaching sessions for staff to embed best practices. Training on manual handling in preparation for the cuddle beds.