Tuesday 16th December 2014
Mac Voice, the magazine for Macmillan professionals: Winter 2014
Bev Clark, Macmillan Practice Development Nurse Specialist in Palliative Care at City Health Care Partnership CIC, describes her team's success in providing palliative care training to community nurses
Research consistently shows that most people with advanced illness would prefer to receive care at home. It is therefore vital that community staff have the right resources, and the right skills, to provide accessible and evidence-based care that fits with these wishes.
In 2012, the Community Macmillan Specialist Palliative Care Team in Hull led an end of life skills audit. The audit reviewed the knowledge and skills of community nurses (bands 4 to 7) delivering end of life care to patients at home. The results of the audit identified a lack of knowledge and confidence in areas such as:
- pain and symptom management
- loss, grief and bereavement support
- end of life care for those with non-malignant disease
- advance care planning and recognising dying.
To act on the audit findings, we developed an End of Life Care Academy. The Academy aims to enhance the skills and competence of community nurses, through interactive lectures held within community health centres. Facilitators work within the community, and include members of our multi-professional Community Macmillan Specialist Palliative Care Team, plus local hospice and hospital professionals.
Developing the programme
A 13-week pilot commenced in March 2013, with 12 community nurses (band 5) attending. Subjects were planned to reflect responses to the audit. During 2013, 22 staff attended, with 86% completing the programme. The programme now runs three times a year. Staff must attend the whole course in order to receive a certificate of attendance. However, missed sessions can be attended within the next programme.
This initiative links directly with the Skills for Health Council’s competency requirement for band 5 community nurses, and thus with the underpinning End of Life Care Strategy. It has been embraced as a management priority locally. In addition to band 5 nurses, the needs of the wider workforce are now being addressed. Attendees now include local prison nurses and parish nurses.
Feedback and evaluation
Performance statistics show the number of people dying at home in Hull increased to 46% in 2013 (from 17% in 2008). Participants have demonstrated improvement in end of life care knowledge and skills. Furthermore, feedback indicates sessions are informative and valuable:
'I now feel more confident to have conversations with patients and families.'
'It has strengthened my passion for palliative care.'
Nursing Times nomination
In June 2014 the project was shortlisted for a Nursing Times Award, for Nursing in the Community. We were very happy to be recognised in this way and hope it will help to encourage others to follow our successful approach.
Macmillan Practice Development Nurse Specialist in Palliative Care, City Health Care Partnership CIC, Macmillan Specialist Palliative Care Team, Hull
1 Department of Health. End of Life Care Strategy. 2008