Background In 2015 LOROS Hospice was approached by a doctor about a possible twinning with Ndi Moyo Hospice in Malawi. The doctor is a retired GP who had previously witnessed the good work that they were doing and their need for support. The LOROS Ndi Moyo Hospice Steering Group is responsible for fundraising, managing monies and planning visits. A patient legacy has enabled LOROS to set up a bursary fund which enables a limited number of LOROS staff across all services to visit Ndi Moyo Hospice annually.

Aims It has been agreed that LOROS staff will visit Ndi Moyo to:

• Share ideas, innovation, and best working practice

• Enhance and broaden palliative care training for the benefit of patient care and personal development

• To experience palliative care in a different cultural setting

• Support the acquisition of medical supplies for Ndi Moyo

• Provide opportunities for staff to experience palliative care in diverse environments.

Methods LOROS staff spent seven days visiting Ndi Moyo getting actively involved with daily tasks. They provided feedback on their return and shared new ideas based on their individual experiences. LOROS staff presented relevant topics to Ndi Moyo staff to share palliative care methods and ideologies. Enabling them to identify practical resource needs.

Results LOROS has been able to share knowledge which in turn has improved confidence levels at Ndi Moyo. On a practical level LOROS has provided some basic medical supplies and resources. LOROS has implemented new working processes learnt at Ndi Moyo to improve team working across the hospice. Overall it has enhanced cultural awareness and diversity.

Conclusion The twinning has helped to transform patient care within both organisations through the sharing of skills and knowledge. For LOROS staff the twinning has brought a new level of appreciation for our standards and values.