7 Education and workforce development
71 Both Living and Dying Well1 and the SPPC report Palliative and end of life care in Scotland: the case for a cohesive approach3 which preceded it, emphasised the crucial role of education, training and workforce development in achieving their aims and objectives. Living and Dying Well1 summarised its educational aims as follows:
" To ensure that all health and social care professionals are equipped with the knowledge, skills, competence and confidence to care for the diversity of patients and families living with and dying from any advanced, progressive or incurable condition."
72 To help bring this about, the Scottish Government undertook to support the delivery of improved palliative and end of life care by working in partnership with NHS Education for Scotland ( NES) to develop an educational infrastructure and a national plan for facilitating and delivering education and training for generalists through support for education and training that could be delivered locally. NES appointed a projects manager to take the work forward and established a Palliative Care Project Reference Group. Initial priorities for education and training were identified as advance/anticipatory care planning, communication and general principles of palliative care in a project plan which recognised the need for local flexibility within its intention of developing an infrastructure to support local delivery of nationally agreed education and training.
73 NES has supported the implementation of Advance/Anticipatory Care Planning ( ACP) through a series of awareness raising events and facilitators training, delivered as a result of a successful tender exercise in the summer of 2009. Evaluation of these initiatives has indicated the need for further education and training in ACP and further support for facilitators, and NES will work with NHS Boards identifying specific needs in this area. NES will also work with the Scottish Social Services Council to help meet the need for ACP education and training across sectors. As part of ACP, NES has also supported the implementation of the National DNACPR Policy with the development of a DVD media resource to support facilitators and trainers in relations to 'conversations on DNACPR'.
74 Communication skills have long been recognised as of crucial importance to effective palliative and end of life care, and in collaboration with the NES Long Term Conditions workstream, support has been provided for a range of communication and related projects arising from locally identified needs. NHS Boards were offered the opportunity in July 2009 to bid for funds to pilot or implement existing communication skills education training opportunities using rapid improvement methodology. The information derived from evaluation of these projects will inform further educational initiatives. NES will continue to develop education solutions which support the health and social care workforce to acquire, develop and integrate communication and relationship based skills, values, approaches and attitudes which are consistent with person centred care.
75 A key action of Living and Dying Well1 was the identification by each NHS Board of an education champion to liaise with NES and to facilitate the sharing and spreading of good practice. To these were added facilitators to support and cascade the implementation of ACP. NES will continue to support the infrastructure which underpins local delivery of education and training by further building on and developing support for education champions and facilitators. To date NES has established a quarterly newsletter and conducted events for education champions and facilitators, and a palliative care education website and Managed Knowledge Network (see Additional resources) has been developed to facilitate sharing of resources and good practice and encourage discussion with others.
76 Living and Dying Well1 also identified a role for NES in supporting NHS Boards' implementation across all are settings of the Liverpool Care Pathway for the Dying Patient ( LCP) 21 or equivalent integrated care pathway. Many NHS Boards have appointed facilitators to take this forward, and NES will continue to work with any NHS Board identifying specific needs in this area. NES will also work with the key stakeholders, including Palliative Care in Care Homes Steering Group to identify needs and support implementation across sectors.
77 In addition to these developments, NES is also engaging with the Higher Education providers or institutions regarding support for palliative care education within nursing and Allied Health Professionals disciplines.
NHS Education for Scotland will support continuing implementation of Living and Dying Well1 and Living and Dying Well: Building on Progress by:
- working with NHS Boards and key stakeholders, including the Palliative Care in Care Homes Steering Group to support implementation of national initiatives such as Communication skills, ACP, DNACPR, and the LCP or equivalent care pathways across sectors
- supporting local delivery of education and training by continuing to build on and develop support for education champions and facilitators
- developing education solutions which support the health workforce to acquire, develop and integrate communication and relationship-based skills, values, approaches and attitudes which are consistent with person-centred care.
NHS Education for Scotland will work with the Higher Education providers or institutions to support palliative care education in nursing and Allied Health Professions disciplines.