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Background St Luke’s Hospice developed a comprehensive engagement framework with service users to gather meaningful feedback and implement a co-production and co-design approach.Aims The development of the Patient Experience and Clinical Effectiveness team amplified the voice of service users across the organisation, generating engagement opportunities to help ensure service user feedback remains at the heart of quality improvements, service delivery and future hospice developments.Methods Diverse engagement methods have been developed including regular face-to-face feedback sessions with service users individually and in group environments and telephone feedback to gain real-time insights into the lived experience of service users across all areas of the hospice. This has yielded a high level of service user participation, with this contemporaneous, invaluable feedback allowing for troubleshooting of concerns and helping to highlight the effectiveness of our services.The co-production, co-design approach has seen service users becoming members of hospice strategic groups, working alongside clinical teams to undertake audits, form a reader panel for new resources and informing the development of a new outcomes model for each hospice service.Results Articulating the impact of hospice services in this way has had significant and far-reaching benefits. Service users have reported high satisfaction levels in contributing to the future development of the hospice. A Kind Words campaign via social media helped illustrate the impact of hospice services to those that may need them, thus helping widen accessibility. Staff receive illuminating updates about feedback within their departments, creating positive effects on staff morale, staff retention and providing assurance of high quality care delivery.Conclusion The framework has been successful in raising the profile and enabling the lived experience of people using hospice services to be fully integrated into hospice service delivery and developments.