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<h3>Background</h3> Our 49 bedded respiratory ward achieved national Gold Standard Framework (GSF) accreditation in 2024, a quality hallmark in end-of-life care provision for patients. In mid-April 2025, the Dudley Group NHS Foundation Trust launched a new end-of-life flowsheet following feedback from stakeholders about improvements in recording discussions and preferences with patients. As this represented a change in how the multidisciplinary teams recorded information, and to ensure that key metrics were maintained and to understand the impact of this new approach, we monitored end-of-life identification and care planning outcomes over the subsequent five months. <h3>Methods</h3> GSF champions on the respiratory ward, supported by the specialist palliative care team, conducted regular audits from May to September 2025. These audits tracked key end-of-life metrics, including the proportion of patients identified under GSF and the offer and uptake of Advance Care Plans (ACP). The monitoring process aimed to provide targeted support and education during the transition to the live flowsheet and to ensure sustained adherence to quality standards. <h3>Results</h3> The proportion of patients identified as Gold Standards Framework (GSF) remained relatively stable during the observed period (30.7-39.8%). More notably, offers of Advance Care Plans (ACP) increased significantly from 7.4% in May to 54.5% in September. The data suggest enhanced recording of ACP following the introduction of the live flowsheet, supporting earlier and more structured care planning. <h3>Conclusion</h3> Following the launch of the live end-of-life flowsheet, the respiratory ward demonstrated sustained identification of patients nearing end of life and a substantial increase in the offering of Advance Care Plans. This suggests the new documentation tool supported more proactive, patient-centred care planning without disrupting established identification rates. Ongoing education and support for staff remain important to maintain these improvements and further integrate the live flowsheet into routine practice, ultimately enhancing end-of-life care quality.