Providing care with confidence

Autumn 2011 

GP Facilitators Dr John McPhee and Dr Neil Reynolds developed a successful online course to help GPs better manage palliative care symptoms clinical experience.

The students acquire new sets of knowledge and skills, for example from the Gold Standards Framework and the Liverpool Care Pathway. Each student is allocated a tutor (ie clinical nurse specialists, consultants or GPs) who keeps regular email contact throughout.

 

We have found that a tutor employed for 3–4 hours per week can support 10 students. What was originally a postal system is now online and a Macmillan grant is used to meet the cost of tutors and course fees. The main cost to each doctor is the week of study leave for a hospice attachment.

Why it has been successful

The course has introduced GPs to local hospices where they’ve set up lasting relationships with specialist colleagues for future advice. Input from GP palliative care facilitators, local palliative medicine consultants, Teesside University, the cancer network and Macmillan has ensured we provide a high-quality course. Other successful elements include:

 

- having personal tutor support

 

- using a practical learning style

 

- closely linking theory and practice

 

- meeting the personal development plan needs of many GPs

 

- ensuring value for money

 

- the consistent financial support of Macmillan has reduced the cost to students.

 

The material has also been used successfully in other parts of the UK and so far over 400 students, mostly GPs, have successfully completed the course.

Evaluation

An independent evaluation was carried out by two academic sociologists two years after the course began. This was to determine if the GPs who had completed the course were aware of it having changed their clinical practice.[6]

 

The doctors surveyed reported increased levels of confidence, knowledge and skills in palliative care. Another formal evaluation will be completed this year, but an informal questionnaire in September 2010 gave very positive feedback from students over the previous two years. Comments included:

 

- ‘This was a fantastic course, from which I learned a huge amount. It has positively impacted my care of palliative patients both during the course and ever since.’

 

- ‘I now know where to look things up and have good communication with hospice and Macmillan nurses locally. The week in hospice was particularly useful for networking.’

Going forward

Many nurses working in palliative care, both as community and specialist nurses, now have prescribing skills. We plan to make this course more accessible to them in future. The course outcomes will be the same as they are for GPs.

 

A number of other areas in the UK are running the course this year with their own funding arrangements. We are grateful for the continuing support of Macmillan.

Facts

- The average GP will have to deal with 15–20 predictable patient deaths a year, of whom only five are likely to have had cancer. See our infographic on Pintrest|.

 

- 400: The number of students, mostly GPs, who have successfully completed the course.

 

- One tutor employed for 3–4 hours per week can support 10 students.

References

1. Lloyd-Williams M and Carter Y. The need for palliative care to remain primary care focused|. Family Practice. 2002. 19: 219–220.

 

2. Royal College of General Practitioners. Curriculum Statement 12|. January 2010.

 

3. Watson M. Principles of palliative care|. InnovAIT. 2008; 1(4): 250–256.

 

4. Higginson I and Sen Gupta GJA. Place of care in advanced cancer. Journal Pall Med. 3:287-300.

 

5. Munday D and Dale J. Palliative care in the community|. BMJ. 2007. 334:809.

 

6. Jackson S and Stevenson C. Practical Palliative Care for General Practitioners - final report to Teesside University and Macmillan Cancer Relief. 2004. (Unpublished).

More  information

Email Dr John McPhee|, Course Director or email Jill Banks Howe|, Principal Lecturer on End of Life Care at the School of Health & Social Care, Teesside University.