Background The Quality End of Life Care for All (QELCA®) programme uses transformational learning (Mezirow. Transformative learning theory. In Illeris (ed.) Contemporary theories of learning. 2^nd ed. Routledge; 2018) to support critical self-reflection, evaluation and action planning for change (Gillett, Bryan. BMJ Support Palliat Care. 2016;6(2):225–230). Since 2016, we have used this approach to support teams in the local area. By observing our practice and critically reflecting on their own, participants have made real change in the way they support people approaching the end of life in their care settings. Our work to date has predominantly focused on care homes.

Aim We aimed to offer QELCA® to local GPs and paramedics (in two separate groups), to find out if this approach would be feasible and effective in supporting them to reflect on the care they provide to people at the end of life.

Method We recruited paramedics and GPs to attend QELCA. Prior to and post attending, individuals were asked to complete questionnaires relating to confidence, knowledge and attitudes towards delivering end of life care. Individuals identified change projects, which were monitored and fed back at the end of the action learning sets which participants attended after the core 5-day experience at the hospice.

Results Two QELCA® courses were delivered, one for GPs (n=6) and one for paramedics (n=5). Questionnaire data show that all participants increased in confidence and knowledge in delivering end of life care. Participants made plans to change their practice at individual and organisational levels. Themes around changes made include communication around future care planning, strengthening relationships with local palliative care teams, developing ways to support staff and organisational processes to prompt end of life care discussions and planning.

Conclusion QELCA® offers GPs and paramedics a reflective space to experience end of life care in a specialist setting, and with skilled facilitation, enables deep reflection to happen so change can take place at personal, team and organisational levels.