Background/introduction A number of service changes (expanded opening hours, increased access to contraception) were implemented within existing resource and were successful at reversing GUM declining attendances trend. We describe and evaluate a “grass roots” process used in our clinic to do this.

Aim(s)/objectives The aims were to evaluate:

• Impact of the process on staff motivation and team dynamics

• Staff perspective on the change process

Methods Clinical leads outlined change triggers and engaged team in vision development during a series of away mornings. Subsequently, staff members took lead on designing, planning and implementation of work streams. All staff were invited to complete a survey monkey questionnaire exploring personal experience of change, impact of change on team dynamics and job satisfaction 3 months afterwards.

Results 17/19 potential respondents completed the questionnaire either fully or partially. 9–11/17 (53–65%) felt they were very supported in the process. 11–14/17 (65–82%) felt the team work was collaborative and problem solving. 7/14 had no change in their job satisfaction, rated as good. 2/14 rated their job satisfaction as very poor before the process, but no one (0/14) did so afterwards. No staff rated their job satisfaction as excellent before the changes and 1/14 did so afterwards. Factors cited by staff to positively influence the process were feeling valued, a clear vision, using the SMART goal model to problem solve. 9/17(53%) would recommend this process to other departments.

Discussion/conclusion We have delivered effective change whilst empowering individuals and teams and improving patient care, all within resource.