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Introduction A recent national survey of carers found that only half of family carers providing end of life care received the support they needed and this support was less likely to be provided in hospital.1 Similarly, a study of discharge in older adults found that most family caregivers are not involved in discharge decisions.2 Aims This study aims to understand and support family in the work they do to facilitate end of life discharge. The study objectives are to: Design and assess the usability of the intervention for family members supporting a person being transferred from hospital to their preferred place for end of life care. Implement the intervention in hospital practice to reveal the factors that promote and inhibit implementation of the intervention; and develop toolkits to facilitate transfer of the intervention between settings. Methods The intervention integrates tested support components (reduction of uncertainty, information provision and coaching) within the framework of Family Sense of Cohesion Theory, to promote family resilience and, thereby, facilitate effective 24/7 care. The intervention has been clinically modelled with practitioners as conversational prompts, each addressing an intervention component (meaningfulness, uncertainty, comprehensibility and manageability). Using Participatory Learning and Action (PLA) methodology the study will be conducted in five developmental cycles. Results The intervention will be piloted at three clinical sites from July 2016. Following this, there will be further roll out to 7 additional sites across England (through to September 2017). References National Council for Palliative Care.Who Cares? Support for carers of people approaching the end of life. London: The National Council for Palliative Care; 2013 Waring J, Marshall F, Bishop S, et al. An ethnographic study of knowledge sharing across the boundaries between care processes, services and organisations: the contribution to 9safe9 hospital discharge. Health Services and Delivery Research 2014;2(29)

Aims Staff working in hospice and palliative care need to be valued, given support and work to high standards. Good supervision acts as a protector against "burn out", builds a resilient work force and is a requirement for registration of some professional bodies. The nursing and midwifery councilMarch 2015 stated; " Clinical Supervision is an activity that brings skilled supervisors and practitioners together in order to reflect upon their practice" Anecdotal evidence suggests that supervision initiatives eventually fail, particularly if the hospice leadership changes. The CEO and clinical leaders at the hospice were determined to set up a top down service and employed a consultant to assess the need and deliver a programme of teaching and learning that could be sustained. Method Assessment showed some senior members of the multi professional team received excellent external supervision. Amodel of group supervision for those not included would be developed for clinical staff. Subsequently an amended model would be used for staff and volunteers e.g. fundraisers and retail staff. Recommendation was to use a whole system approach and identify staff willing to train and become internal supervisors. A two day training programmewhich included contracting, boundaries, confidentiality, reflection and group work theorywas devised and delivered to 20 perspective supervisors. They received a half a day update and regular debriefs. All staff were trained in the use and expectations of supervision. Day course organised for fundraisers etc. Supervision model The model adopted was to promote empowerment, learning, build confidence and self-esteem, growth and support. Individual self-reflection, awareness and the quality of care was prioritised. Review and evaluation Review after 3 sessions. Evaluation after 1 year.

Background Palliative care remains a new discipline within Serbia, thus there is a need for a comprehensive programme of continuing education and formal higher education for palliative care (PC). Prior to 2011, there was no formal palliative care training incorporated into the undergraduate curriculum for health and social care professionals. Therefore the introduction of palliative care into the curriculum for doctors, nurses and social workers was a key component of the development of palliative care. Aim The aim was to integrate pc into the undergraduate curricula of medical, higher nursing and social work curriculum in Serbia. Methods A team of national and international experts led the process. For each discipline, contact was made with the appropriate Deans, meetings held with representatives from the different faculties, and a curriculum development process established. Existing curricula were reviewed, where they existed e.g. for the medical schools and curricula drafted based on international guidelines/experience. Results Comprehensive training materials have been developed, including facilitators guides, presentations and student handbooks, as there is no comprehensive Serbian PC book. The curriculum has been integrated into the undergraduate medical course in all five medical schools in Serbia i.e. the Universities of Belgrade, Novi Sad, Kragujevac, Nis, and the Military Medical Academy. The process of acceptance into the higher nursing schools is ongoing but it is anticipated that at least half of the schools will integrate palliative care as a mandatory course. For social workers, palliative care will be taught within the curriculum for the first time from October 2013. Conclusion Integration of pc into the undergraduate curriculum for health and social care professionals is vital in the development of pc. Working in collaboration with the different faculties is key to integration, along with development of comprehensive training materials in accordance with European and International standards.