131 The impact of COVID-19 on the management teams of Irish specialist palliative care services

<h3>Introduction</h3> This qualitative study examines the impact of the COVID-19 pandemic upon managers in specialist palliative care (SPC) services in Ireland, in order to identify unmet needs. <h3>Objectives</h3> To understand the impact of covid-19 on managers of SPC services in terms of workload, stress, resilience. To understand how SPC managers are dealing with this stress. To explore how SPC managers approached the challenges posed by the pandemic and changed service provision in response to it. To identify perceived needs there are to be met in order to future proof specialist palliative care services. <h3>Methods</h3> A qualitative study design with semi-structured interviews using Microsoft Teams was adopted. All participants occupied management level positions within Irish SPC services. Recruitment was carried out at two sites differing in terms of location, structure and governance. NVIVO software was utilised to facilitate data organisation and the seven steps of Framework Analysis were used to analyse the data. <h3>Results</h3> 13 interviews were conducted with participants from medical, nursing, allied health professional and support services backgrounds. Major themes identified were challenges and opportunities faced in the managers’ role, sources of stress, coping mechanisms and ‘future proofing’ palliative care service provision. Despite reporting symptoms consistent with stress and burnout, no participants sought formal support. All managers cited informal peer support as an important coping mechanism alongside family and exercise. Improved pathways of mentorship and training for new managers and enhanced staffing levels were cited as vital to ‘future proof’ the speciality. <h3>Conclusion</h3> This study provides important insight into how managers in SPC services experienced and responded to the pandemic on a professional and personal level. Organisational and policy level changes are needed to better support managers in SPC services in the future in terms of pathways, training and adequate staffing.