Aim A hospice in South East London has been engaged in a major programme of change to support its new strategic priorities. This presentation will provide an overview of the change management programme.

Methods The hospice recruited a senior manager to work as service development and transformation lead. Her focus was on change that would allow the hospice to reach more people using an increasingly finite resource of people and money.

Results Over the last two years the post-holder has been engaged in projects focused on:

• establishing the new Single Point of Contact

• designing and utilising a case management approach to guide the allocation of our resources (staff, skills and services)

• improving clinical decision making and related communications between professionals

• introducing a new electronic patient records system

• redesigning clinical administration services to better support clinical professionals.

Working closely with the different clinical directors she has adopted an approach broadly reflective of the PDSA cycle to design and implement change. The work has been overseen by a change board. Much of the change planned has been implemented relatively quickly and results are impressive. However, some resistance exists within the workforce, the impact on staff has been significant and further work is required to embed the changes and ensure new ways of working are sustained.

Conclusion Major change is possible within a hospice context, but it is challenging to implement. Dedicated and senior leadership is required to do this successfully; whilst careful attention to engaging staff in building a vision for something different prior to requiring them to change behaviours is a vital step.