Background As part of a wider advance care planning doctoral research study; hospice patients discussed the communication skills, behaviour and attitudes of hospice staff and volunteers that made a difference to them in their advance care planning conversations.

Methods Video narrative interviews with 15 hospice patients recorded via portable flip video device, transcribed using Transana programme and thematically analysed.

Results In addition to staff and volunteer communication behaviours and skills; the participants identified that their relationship with the hospice daily ebb and flow was key to their motivation and confidence in advance care planning conversations. This took the form of observing interactions with other hospice patients, feeling part of the hospice community, prioritising getting to know the patient as a person and what mattered to them, staff being both ‘intimate and professional’ as well as ‘being human’.

Conclusion Relationships with staff, organisation and the hospice environment engendered a feeling of holistic, person centred care for the participants. This in turn facilitated their confidence and capacity to begin, continue or complete advance care planning conversations.

Relevance to practice It is tempting to consider only the teaching of communication techniques and practices as the road to successful advance care planning conversations. In fact, hospice patients also value a relationship with the ebb and flow of an organisation’s behaviour, attitudes and environment. Hospices should take this into account in their day-to-day interactions with patients, their families, staff and volunteers.