Does palliative and end of life care education make a difference? Once that warm glow of the conference or course has worn off, does it change anything? What is the capacity of programmes of study to change practice and improve outcomes for patients and families? Is it being delivered with careful consideration of the context, culture, legislation and resource availability in which palliative care is practised? These are some of the questions we need to ask ourselves when designing and delivering education and training.
What we do know is that education has the potential to ‘mend the gap’ in so many ways: between theory and practice; models/methods and actual service delivery; ideas formulation and project implementation. Education without practice is limited. Better still is education distilled from clinical practice and built from tried and tested services – what works. Hospices and palliative and end of life care services are sitting on a goldmine of education and training possibilities. Most teachers are clinicians and one can share the lessons of running services and meeting patients and families on a daily basis. Innovation and change is happening on the doorstep. Services and staff daily make real that trinity of care, research and education. With all the challenges of recession and change, we have at our disposal gifts: services are adapting and developing; lessons being learned are for sharing.
Following the example of many palliative care services in the UK, at St Christopher’s, we utilise the experience of our 2,000 patients per annum to roll out education from the roots of a working hospice and service. Just over the last year, senior managers, teachers and clinicians have been undertaking a number of education projects that illustrate this:
‘Hospice as a Hub’ – together with external presenters, staff have talked about the major reconfiguring of our services following a ‘hub’ (wheel and spoke) model of a range of services offered from the hospice. This has resulted in increased uptake of more flexible services, further community engagement and improved social care integration and has attracted significant interest.
‘Celebrating Care homes’ – a two day conference attended by 200 participants from specialist palliative care and the care homes sector. It showcased areas of research, education and service improvements. Day two was spent taking delegates in groups out to Care Homes to see end of life care initiatives in action, e.g. reflective debriefing sessions. It also engaged Care Homes in teaching.
‘Quality End of Life Care for All’ (QELCA) – a training programme for generalists – managers and clinicians in end of life care, through classroom sessions and practice observation. Focussing on changing attitudes as well as offering knowledge and insight into skills, the programme is followed by a series of learning sets where participants meet in groups to look at the implementation of their plans for service improvement. This has been followed up by a Training the Trainers programme in conjunction with Help the Hospices with hospices around the country working with local hospitals.
Education is the fuel that drives good practice, good patient care and good service delivery.
Director of Education and Training, Education Centre, St Christopher’s Hospice, London