Background: Over the past few years, the local Heart Failure (HF) team has improved their palliative care knowledge and skills, particularly developing confidence with prognostication: this process started with joint working between the specialist palliative care (SPC) and HF teams on a ‘Principles of good palliative care’ project in 2010. Prior to the project, the HF team undertook a documentation audit to review their management of the palliative care needs of their patients. Teaching sessions followed, with subsequent time to embed into practice the principles of good palliative care, including optimising communication with primary care regarding needs and likely prognosis.

Aims: We set out to understand better whether the HF team’s journey resulted in good quality palliative care delivery to their patients.

Methods: We first closed the audit loop to ascertain whether the clinical records evidence any change in practice, and then set up a sequential focus group study with the HF team to understand in what ways their practice has changed and how this impacts on quality of care delivery.

Results and discussion: Qualitative analysis is ongoing but seems to suggest significant changes in how the team now approaches and coordinates patient care, and provides insight into how this translates into quality of care. We will present the findings of the audits (pre- and post intervention) as well as the final
analysis of the focus group study. We will specifically consider how team culture influences quality of care delivery.