Workforce development and training: Exploring barriers to a universal approach to end of life care

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Summary of report content

Healthwatch Staffordshire undertook a project to look into End of Life Care (EoLC) during 2016-17. This was identified as a priority area of focus following a public consultation and was also informed by local intelligence which indicated there were discrepancies in the way EoLC was provided across the county and West Midlands region. The purpose of the project was to explore the barriers to a consistent, holistic approach to EoLC across Staffordshire, Walsall and Wolverhampton. Three primary areas to research were identified: Advance Care Planning (ACP), Workforce Development and Pre and Post Bereavement Support. This report focuses on Workforce Development and aims to identify the skills and experience of the EoLC workforce, what systems and processes can be put in place for effective multi-disciplinary collaboration, and what training needs to be put in place to help staff do their job effectively. The study used questionnaires as the main data collection method, sent out to End of Life education trainers in the various hospices and hospitals within Staffordshire, Walsall, and Wolverhampton. This research was led and completed by Engaging Communities Staffordshire (ECS)/Healthwatch Staffordshire, with input and support from Douglas Macmillan Hospice and University Hospitals North Midlands (UHNM). The report also includes an intensive literature review. The key findings of the study are as follows: - The palliative workforce is in crisis and requires key changes to survive. The barriers that prevent effective multi-disciplinary collaboration were identified as: difficulty in recruiting and retaining staff, an increasing workload that prevents staff from undertaking training, the cost of training and the lack of resources. - The current training and development needs to go beyond the basic academic knowledge to include specialist training such as spiritual care training, communication skills training and resilience and stress management training. - The lack of palliative care staff needs to be dealt with. One mid-term solution could be to merge their workloads with those of generalist staff who have a similar role to specialist palliative care staff to increase efficacy and reduce duplicity. - The Electronic Palliative Care Co-ordination Systems (EPaCCS) is used to record and share patients’ end of life care preferences. The system has been beneficial overall for EoLC but it is not able to effectively work across sectors to include other organisations (e.g. ambulance services) involved in the care of patients, due to data protection issues and lack of communication. The report makes three recommendations: 1) Improvements need to be made to the current system (EPaCCS) used to record and disseminate EoL plans to ensure everyone involved in a patient’s care can access the relevant information to enable better joint working. 2) Training should go beyond the academics and theory to include specialist training such as spiritual care training, and should utilise more interactive methods to deliver the training. 3) Enable the release of the workforce for training – for example this could mean using a more effective rota system, using volunteers for non-medical activities.

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General details

Report title 
Workforce development and training: Exploring barriers to a universal approach to end of life care
Local Healthwatch 
Healthwatch Staffordshire
Date of publication 
Sunday, 20 August, 2017
Type of report 
Key themes 
Communication between staff and patients
Cost of services
Digitalisation of services
Patient records
Quality of staffing
Service delivery organisation and staffing
Staff levels
Staff training
Healthwatch reference number 

Methodology and approach

Was the work undertaken at the request of another organisation? 
Not applicable
What type of organisation requested the work 
If this work has been done in partnership, who is the partner? 
Engaging Communities Staffordshire (ECS)
Primary research method used 
How was the information collected? 
If an Enter and View methodology was applied, was the visit announced or unannounced? 

Details of health and care services included in the report

Secondary care services 
End of life care

Details of people who shared their views

Number of people who shared their views 
Not known
Age group 
Not known
Not known
Not known
Sexual orientation 
Not known
Does the information include public's views? 
Does the information include carer's, friend's or relative's views? 
Does the information include staff's views? 
Does the information include other people's views? 
Not known
What was the main sentiment of the people who shared their views? 

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Does the information contain a response from a provider? 
Not applicable
Is there evidence of impact in the report? 
Is there evidence of impact external to the report? 
Not known

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.