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P51 Six steps + widening the access to good EOL care
  1. Gail Wilson,
  2. Paula Hine and
  3. Judith Talbot
  1. St lukes Hospice, Plymouth, England


The Six Steps + project aimed to create a local hospice accredited EOL quality kite mark to support local health and social care providers build their knowledge, skills and confidence in delivering EOL care. The project built on previous work by the North West and includes additional assessments and workshops on dementia and learning disabilities. The project was supported by Burdett Nursing Trust and local commissioners who wanted to see improved standards of EOL care.

The Six Steps + programme has been running for the last 12 months and currently has 66 organisations and 131 individuals registered. The programme has been very successful and has delivered real service improvements eg the last post death audit (412 deaths), demonstrated that 42% of individuals who died had an Advance Care Plan in place and the number of inappropriate hospitals admissions fell from 40% to 23%.

The project truly promotes integrated working. The hospice equality mark is now published in the local authority’s online public directory. Organisations stated they wanted to have a local quality mark linked to the local hospice which families recognise. The EOL Link Forum is pivotal to service integration as well as being a vehicle for ongoing audit and monitoring end of life outcomes.

The programme does not provide any educational credit therefore Skills for Care was approached to accredit the programme. This resulted in a national mapping tool being created to map the Six Steps to the new Quality Credit Framework EOL qualifications.

The next step for the project is to create a train the trainer programme to help others implement Six Steps + in their area. Hospices cannot provide all EOL care and they have an important role in enabling providers in their communities to deliver good quality equitable EOL care for all.

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