Background The 2015 palliative care budget is €72 million (Euros) but up to €1.3 billion spent on end of life care annually – much of this larger figure unplanned and uncoordinated. Geographic and other inequities evident in palliative care provision.

Aim Build support for the development and implementation of a National Strategy on Palliative Care, End of Life and Bereavement.

Method Multi-layered approach to raising awareness and building consensus:

• Targeting the correct audience who can make change happen

• Presenting robust evidence including costs justifying reform and investment

• Demonstrating that issues affect a significant number of people

• Sharing experience and knowledge

• Knowing their policy priorities

• Staying resilient – advancing and introducing new angles to argument

• Engaging directly as advocates within the political system at all political levels – developing relationships with politicians

• Identifying advocates in the public service to promote policy change

• Using a variety of new and existing projects and programmes

• Encouraging patients and families to be self-advocates – using a novel project for discussing and recording future care preferences

• Supporting healthcare professionals to become effective advocates for patients

• Creating alliances to lobby for policy development

• Using media opportunities to sell the message

Results The recognition of the importance of a strategic approach to palliative and end of life care acknowledged in Parliamentary Committee Report affords an opportunity to develop further policy and practice.

Conclusion This a long – term exercise, dependent on supporting the implementation plan, building momentum and promoting a public dialogue on sensitive issues around dying, death and bereavement.