Palliative care strategy: Palliative Care Matters for All

Outcome 8: Employers, professional bodies and education providers will make sure that staff who deliver palliative care are trained, skilled and supported.

It is essential that our workforce is built, trained and sustained so that the multi-agency staff working in primary, community and secondary care and in third sector organisations can deliver palliative care and specialist palliative care for adults and children, including care around dying, and that education, training and up-to-date resources are made available, with protected staff time and full accessibility.

The NES/ Scottish Social Services Council (SSSC) Palliative Care Education Framework provides a clear and robust structure for education and training, and should continue to form the basis of palliative care education for all health and social care staff in Scotland caring for adults or children.

The Scottish Palliative Care Guidelines provide practical, evidence based information to support safe and consistent pain and symptom management and clinical decision making by staff providing palliative care throughout Scotland. These are open access and widely used in training and education. It is essential that this clinical guidance continues to be updated in line with emerging evidence and best practice, and that it is widely available as a 'once for Scotland' resource for health and care staff.

There is a wide range of education and training programmes, including online learning; care home collaboratives; undergraduate and postgraduate training; adult specialist palliative care services education and training; and leadership programmes. Palliative care education is also provided within nursing, allied health care professional and medical university and further education college programmes in Scotland.

Project ECHO (Extension for Community Healthcare Outcomes) already provides education from palliative care specialists and other experts for many groups of staff providing adult or paediatric palliative care at local, regional and national levels.^[31] It has a proven role in offering staff support, and facilitates reflective practice and workplace learning. Staff providing general and specialist palliative care in the community and hospitals benefit from national online networks for education, training and development.

Education programmes

There is a need to enable palliative care education to be delivered consistently across Scotland within pre-registration programmes for foundation doctors, nurses and other health and social care professionals, and in further education college programmes. Palliative care education should be included wherever relevant in the curriculum of undergraduate university programmes for doctors, nurses, pharmacists, allied health professionals and other health and social care professionals.

The learning content of NVQs and SVQs is based on the National Occupational Standards in the relevant area. These standards define the skills, knowledge and understanding needed to do a particular job. These qualifications provide training that offers learners an opportunity to develop skills and knowledge on palliative care and care around dying, and an understanding of loss, grief and bereavement.

Workforce training in palliative care

Palliative care and care around dying are vital aspects of care provided by health and social care professionals to adults with serious or life-threatening illnesses. Health and social care staff need to have ongoing education and training on the provision of fundamental care for people with palliative care needs relevant to their work roles. This training is key to building the necessary basic knowledge, skills and confidence for health and social care professionals as a baseline for developing interpersonal skills and behaviours related to palliative care. This education is an important underpinning in developing the workforce, and can start with induction training.

There is a need to ensure that palliative care learning resources are well-coordinated and easily accessible, and that staff are aware of the availability of these resources. There is also a need for consistency of approach in the way learning and resources are disseminated and shared across sectors for workforce development.

To ensure a consistent approach in the provision of, and access to, learning and resources across all HSCPs, it is important to consider how they can contribute to the sustainable delivery of consistent and local palliative care training and education across their areas. Similarly, Health Boards need to consider appropriate education and training for hospital staff.

Paediatric palliative care training

Clear training pathways for paediatric palliative care across Scotland are important to enable health and social care staff to have the basic skills and knowledge to deliver palliative care across different settings, relevant to their role. Education resources are currently delivered by a number of key stakeholders, including the Paediatric End of Life Care Network (PELiCaN); the Managed Service Network for Children and Young People with cancer; NES; CHAS; and specialist paediatric palliative care teams.

Paediatric palliative care training should be part of the undergraduate and paediatric pre-registration nursing training curriculum, where relevant, and within the curriculum of postgraduate qualifications in child health. Paediatric staff, as well as medical, nursing (including advanced practice) and specialist practitioners, should have access to a range of relevant opportunities for training and education within paediatric palliative care services.

As part of the finalisation of the strategy and development of the delivery plan, Scottish Government will work with delivery partners to further develop the following proposed actions, timings and appropriate governance arrangements:

8.1. Work with HIS to ensure there is sustainable management, updating and extension of the Scottish Palliative Care Guidelines as recommended best practice for symptom management across Scotland on the Right Decision Service; and explore options to develop and include Scottish paediatric palliative care guidelines.

8.2. Work with NES to develop a designated online learning space, readily available to all health and social care staff who deliver palliative care to adults, children and young people, that provides a single point of access to relevant training and education resources on palliative care, care around dying and bereavement support.

8.3. Work with NES, statutory and third sector organisations, and education providers to support and enable local and national education and training for health and care staff to equip them to have sensitive and effective person-centred conversations with adults or children, families and carers, that are central to future care planning, palliative care, and care around dying, including NES Having Realistic Conversations resources.

8.4. Work with NES and third sector palliative care education providers to promote and develop online learning opportunities and networks for health and social care staff across Scotland, such as Project ECHO.

8.5. Work with universities and further education colleges that provide pre-registration courses and undergraduate education programmes to enable all health and social care staff (including doctors, nurses, pharmacists, allied health care professionals and social workers) to receive a level of adult or paediatric palliative care education appropriate to their roles.

8.6. Encourage HSCPs and Health Boards to employ palliative care practice educators to support the sustainable delivery of palliative care education and training in line with the NES/SSSC Palliative Care Education Framework, and work collaboratively with adult and paediatric palliative care specialists offering education and training.