Tag Archives: Education

PATCH charity supports End of Life Care student project

Posted: 11 March, 2019

The Chairman of the Scottish palliative care charity PATCH, Sir Michael Nairn, has visited Ninewells Hospital to meet with clinicians and final year medical students involved in an innovative communications programme.

Sir Michael Nairn (third right), Dr Fiona McFatter (centre) with final year medical students and course tutors

NHS Tayside Press Release – 6 March 2019 – PATCH has donated £34,000 to support clinicians and communication skills tutors to create and deliver a specialist communications course for medical students tackling end-of-life conversations. This course is supported by NHS Tayside and the University of Dundee and is part of a four-year charity-funded project.

Sir Michael participated in one of the teaching sessions funded by the charity. He was welcomed by Dr Fiona McFatter Palliative Medicine Consultant, who explained the importance of the communication sessions which are now delivered as a core part of the medical undergraduate course.

Palliation and the Caring Hospital (PATCH) is the first charity specifically to support 24/7 specialist palliative care for patients in hospital, by funding hospitals to provide resources such as dedicated beds, staff training, advisory services and research.

Dr McFatter, who is also Undergraduate Teaching Lead for Palliative Medicine, said:

We are delighted that PATCH is supporting this very important project. Research shows that medical students and junior doctors do not feel well prepared for talking with patients and relatives about end of life care and dying.

This project will help to improve communication around death and dying and, in doing so, help meet patients’ wishes at the end of life.

The course aims to help students manage difficult conversations with families and patients, focusing on care in the last weeks of life, treatment decisions and their wishes for end-of-life care. The aim is to prepare students for work as Foundation Doctors and enable them to have these conversations in a supportive and sensitive way that helps patients and their families.

Sir Michael Nairn said:

I am delighted to have seen first hand the outstanding work being done by the University of Dundee Medical School and Ninewells Hospital in the training of medical students in such an important aspect of their future professional work. Modern medicine is impressively advanced in so many ways, but life will come to its end for all of us and the doctor will so often play a pivotal role in events leading to death – both with the patient and the members of the patient’s close family.

This course, I am sure, will contribute significantly towards giving confidence to young doctors in sensitive handling of difficult emotional issues for patients and their families in times of great personal stress.

Final year medical students were introduced to challenging scenarios through videos, group discussions and simulated patient consultations which explored the sensitive subjects of dying, death and bereavement.

Sir Michael also took the opportunity to meet with clinicians who developed the course and to chat with final year medical students and hear feedback on the difference the course made to them. He was also able to speak with the simulated patients who are integral to the success of the course.


PATCH funds three palliative care courses for band 5 nurses in Glasgow hospitals

Posted: 4 March, 2019

Following a successful first course in 2018, PATCH is funding two further nursing courses in 2019.

By George Allison [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons, original modified

The courses were developed and delivered by NHS Greater Glasgow & Clyde, the Prince & Princess of Wales Hospice, and Glasgow Caledonian University, with support from PATCH funding to cover the “backfill” for nurses. During the 5-day course, the nurses learn about symptom assessment and management, with 15 Band 5 nurses attending each session. By the end of 2019, the training will have been delivered to 45 nurses.

In order to take part, each nursing applicant had to submit a 250 word statement indicating why they would like to undertake the module and how it would help their practice, as well as evidence of their senior ward nurse support. The first course was overbooked and those attending included nurses from many different acute settings: respiratory medicine, general surgery, emergency medicine, medicine for the elderly, palliative care, vascular medicine, renal, neurology, ENT, endocrinology, gastroenterology and urology.

The course was evaluated midway, on completion and three months later.

Midway through the course a participant from Queen Elizabeth University Hospital commented:

This has been so valuable in reminding me, us really, how important our job is in the hospital setting and that we are all already palliative care nurses. A palliative approach is an escalation not a de-escalation – I loved that and am shamelessly stealing it.

When interviewed three months later as part of the evaluation, another participant commented:

I think they have a person who is better trained looking after them. I can now give myself rather than find someone else.

After the first course, all 15 nurses said they would recommend the course to their colleagues.

Congratulations to Claire O’Neill, lead palliative care nurse Greater Glasgow and Clyde and to her enthusiastic colleagues Elaine O’Donnell and Liz Smith, practice development facilitators for palliative care NHS Greater Glasgow and Clyde and the Prince and Princess of Wales Hospice, Glasgow respectively.

For further details of the course and its evaluation please contact Elaine.O’Donnell@ggc.scot.nhs.uk.

Nurse working in the Royal Infirmary of Edinburgh graduates with a certificate in palliative care

Posted: 16 August, 2017

Carol Ann Smith, who works in an acute surgical ward in the Royal Infirmary of Edinburgh, recently graduated with a certificate in palliative care. The funding for her course, which is organized by St Columba’s Hospice and Queen Margaret University Edinburgh, was provided by PATCH.

PATCH aims to enhance the palliative care skills of nurses working in acute wards in hospitals. If more than one nurse in the ward has such additional training, it will help spread palliative care practice in areas where the busy pace plus complex decision making, can make the delivery of palliative care challenging.

Carol has kindly provided us with feedback about her experience in studying the course.

I have been a nurse for 28 years, first as an enrolled nurse then bridging to staff nurse. During my time nursing I have developed a keen interest in caring and supporting patients and families who need palliative care. Recently I reached out to PATCH to help me fund a palliative course at queen Margaret university. Being an “old fashioned” nurse who trained before the degree courses began I took on the course with some trepidation! However I managed to return their kindness by passing my exams and gaining a post graduate certificate in palliative care.

Caring for a patient who needs end of life care while in a busy hospital ward is a very real challenge, one seen every day of the week in the acute surgical and medical wards of the hospital. Being able to increase my knowledge and skill enough to give best care to those important group of patients was paramount to what I was able to do as a nurse.

Being able to carry on the information and teach those skills to the next generation of nurses was even better.

The support I received from PATCH to achieve these goals have fuelled the fire for me to continue with more study, has given me a renewed sense of purpose and has even paved the way for new beginnings in my career.

I would like to thank and all those involved in PATCH for their kindness and support.

Carol-Ann Smith

PATCH funds communications pilot project at University of Dundee’s School of Medicine

Posted: 14 November, 2016

Simulation-based workshops enable healthcare professionals to hold open and honest discussions with their patients.

PATCH (Palliation and the Caring Hospital) has funded a project at The University of Dundee to help doctors care for and communicate more easily with those at the end of life. The support for the project was marked with the unveiling of a plaque at the School of Medicine’s Institute of Healthcare Education (IHSE) in Ninewells Hospital on 1 November 2016.

From L-R: Professor John Connell, Chairman of NHS Tayside; Dr Ben Shippey, Director, Institute of Healthcare Skills Education; Dr Gordon Paterson, Director, PATCH; Mrs Trudy McLeay, Director, PATCH; Sir Michael Nairn Bt, Chairman, PATCH; Sandy McDonald, Consultant for Thorntons LLP; Dr Stephanie Sim, NHS Tayside; Dr Pam Levack, Medical Director, PATCH.

From L-R: Professor John Connell, Chairman of NHS Tayside; Dr Ben Shippey, Director, Institute of Healthcare Skills Education; Dr Gordon Paterson, Director, PATCH; Mrs Trudy McLeay, Director, PATCH; Sir Michael Nairn Bt, Chairman, PATCH; Sandy McDonald, Consultant for Thorntons LLP; Dr Stephanie Sim, NHS Tayside; Dr Pam Levack, Medical Director, PATCH.

Professor John Connell, Chairman of NHS Tayside, and Dr Ben Shippey, Director of IHSE, were on hand to recognise the unique collaboration between PATCH the University and the NHS.

The three organisations have come together to develop and pilot a series of workshops to equip young healthcare professionals with the skills they need to have honest and open conversations with patients and their families about dying– particularly with those people whose needs might be better served by active palliation of their symptoms rather than other healthcare interventions.

The unveiling of a plaque to recognise a unique collaboration between the University of Dundee, the NHS, and PATCH.

The unveiling of a plaque to recognise a unique collaboration between the University of Dundee, the NHS, and PATCH.

The half-day sessions began in March 2016, and include open discussions, practical opportunities and expert feedback. The activity is simulation-based, with debriefing by skilled faculty using video recordings of conversations with simulated patients and actors.

The School of Medicine ultimately aims to open the workshops to healthcare providers from other institutions around the country, and to share materials and resources needed to deliver the training.

Dr Ben Shippey, Director of IHSE, said:

“In Western societies we seem to have lost our way with regard to recognising and caring for people who are dying.”

“Advances in medical technology mean there is an overwhelming pressure to offer treatments to people where the benefit to them is less clear, because it can be psychologically easier for healthcare professionals to commit to unpleasant — and ultimately futile –treatments than to ask ‘are you really sure that’s what you want?’”

“The skills healthcare professionals need to engage with these open and honest conversations can be learned — and we in the IHSE believe we can deliver that learning effectively and efficiently using simulation-based learning.”

The issue of appropriate patient care is a timely one.

Scotland’s Chief Medical Officer Dr Catherine Calderwood used her 2014-15 annual report, Realistic Medicine[1], to challenge healthcare providers to reduce the waste and harm from unnecessary treatments by actively engaging in a process of shared decision making with patients.

And earlier this month, the Academy of Medical Royal Colleges published a list of 40 commonly-used treatments that bring little or no benefit to patients as part of their Choose Wisely campaign[2], which is designed to highlight the need for patients and doctors to talk frankly about how health issues should be treated.

“We hope this training will be a step towards a cultural shift,” Ben said, “such that healthcare professionals acknowledge they can make a real difference by actively managing dying for more patients, and take a step away from delivering what they can do toward asking what they should do for people at the ends of their lives.”

Pam Levack, Medical director of PATCH, commented:

“We are so pleased to be able to support this project, as it really reflects one of the serious issues which PATCH was set up to address – the improvement of communication between medical professionals and patients and their families at the end of life.

“Should palliative care be the most realistic and best option for patients, it is so important that doctors and nursing staff feel comfortable, equipped and trained to discuss this openly. It requires compassion and understanding and an ability to relate to patients and their families at a time when they are most frightened.”

“PATCH believes it is vital to be able to discuss what is happening to patients to make a real difference to their care at the end of life.”

“This is an excellent project and we hope that it is just the beginning for other similar initiatives across the NHS.”

Further information

References and Footnotes

  1. NHS Scotland. (2015). Realistic Medicine, Chief Medical Officer's Annual Report [Accessed: 3 November 2016]. ↩
  2. Academy of Medical Roya1 Colleges. (2016). Forty treatments that bring little or no benefit to patients. [Accessed: 3 November 2016]. ↩

A lack of training for doctors and nurses as a cause of inadequate end-of-life care.

Posted: 9 September, 2015

To ensure staff are providing palliative care for patients in hospital, ward doctors and nurses need more training.

On the 4th of September 2015, The Times reported on patient’s receiving inadequate end-of-life care due to a lack of training for doctors.

The article reports on expert opinion that the medical profession is too focused on the ‘war on disease’ to give adequate time to end-of-life care. This opinion expresses that doctors may be too scared to discuss death or a patient’s needs, and that simpler touches such as consoling bereaved relatives are being neglected. [1]

There is a serious gap in palliative care provision in hospitals. In a 2014 report by the Royal College of Physicians, it was reported that only 21% of 150 individual hospital sites surveyed had access to face-to-face palliative care services 7 days a week. This is despite a longstanding national recommendation that this be provided. [2]

However, this news article highlights a further need: To provide a satisfactory level of training to doctors and nurses who may not necessarily be palliative care specialists.

Despite national recommendations to provide such training, the 2014 report by the Royal College of Physicians found that only 19% of trusts surveyed required doctors to undertake mandatory training in care of the dying. 28% of these trusts required nurses to undertake this training. Furthermore, 18% had not provided any end of life training.

PATCH is committed to ward staff increasing their palliative care skills and ensuring adequate specialist palliative care staff are available.

The needs of patients nearing the end of their life will only be met when all ward staff are comfortable looking after patients (and their families) with palliative care needs, and specialist staff are available to advise on more complex issues including hard to control pain.

Hospitals need more nurses and doctors with palliative care skills. End of life care in our hospitals should be as good as care at the beginning of life.

This message, among other comments, are given below in PATCH’s letter responding to the news article in The Times.

Dear Sir,

Oliver Moody (4th September) stated that “hospitals struggle to cope with patients who are dying”. Over 50% of people in the UK die in hospital, yet often there are only a handful of specialist palliative care nurses and doctors working with ward staff for hundreds of patients that require end of life care. Only 5% of people die in hospices operated by specialist nurses and doctors caring for perhaps 20 – 30 patients.

Hospital patients deserve to have the same quality of care as in a hospice. In a busy hospital with conflicting pressures, it takes extensive training and skill to recognise when a patient is dying, ensure patients are comfortable and free of pain in their final days, and discuss everything with patient and family. Hospitals need more nurses and doctors with palliative care skills. End of life care in our hospitals should be as good as care at the beginning of life.

PATCH is a new charity dedicated to ensuring patients and their families have access to skilled palliative care 24/7. We strongly encourage people passionate about end of life care to contact us at patchscotland.com.

Sir Michael Nairn Bt Chairman
Dr Pamela Levack Medical Director
PATCH Scotland, Dundee

References and Footnotes

  1. The Times. Lack of training blamed as doctors fail dying patients, Article, [Accessed 7 Sep 2015]. ↩
  2. Royal College of Physicians. National care of the dying audit for hospitals, England National report May 2014, [Accessed 7 Sep 2015]. ↩

PATCH funds Graduate Certificate in Palliative Care for nurse working in acute setting

Posted: 14 July, 2015

PATCH is delighted to support Carol Ann Smith, a staff nurse working in the hepatobiliary surgical ward in the Edinburgh Royal Infirmary. Congratulations Carol Ann.

She is the second nurse in ward 107 to be funded by PATCH to develop their palliative care knowledge and skills – staff nurse Jane Davis is presently doing her MSc.

Carol Ann already leads the ward’s Compassionate Care approach and will be actively involved in the new palliative care group within surgery.

Under Senior Charge Nurse Kirsty Tinkler’s leadership, nurses are being supported and encouraged to develop their palliative care expertise in the busy environment of an acute surgical ward.

The Graduate Certificate in Palliative Care

The Graduate Certificate in Palliative Care, is run by St Columba’s Hospice in partnership with Queen Margaret University. The course can be taken by students with or without a degree and involves three degree level modules include pain and symptom control, listening and talking with patients and their family and the psychosocial aspects of caring for the patient and family. The modules can also be accessed and used for degree completion or individual modules can be accessed for Continuing Professional Development.

Further information

For further information about palliative care courses for staff working in the acute setting contact:

  • Janice Logan, Programme Leader MSc and Graduate Certificate in Palliative Care
  • 0131 551 7710
  • jlogan@stcolumbashospice.org.uk

Related article

PATCH funds its first MSc in palliative care for nurse working in the acute setting

PATCH funds its first MSc in palliative care for nurse working in the acute setting

Posted: 17 March, 2015

PATCH is delighted to support its first student in their palliative care education based at St Columba's Hospice in Edinburgh.

A key aim of PATCH is to support palliative care education in the hospital setting. PATCH is therefore delighted to support Jane Davis, a staff nurse working in the hepatobiliary surgical ward in the Edinburgh Royal Infirmary, to do an MSc in palliative care based at St Columba’s hospice in Edinburgh.

Jane had already completed one module and PATCH was happy to support the remainder. Ward 107 in the Edinburgh Royal Infirmary has recently established a palliative care group under the direction of ward sister Kirstie Tinkler and PATCH is especially pleased to be able, in a small way, to be associated with ERI.

Queen Margaret University's main building by Stuart Caie from Edinburgh, Scotland (Flickr) [CC BY 2.0], via Wikimedia Commons.

Queen Margaret University’s main building by Stuart Caie from Edinburgh, Scotland (Flickr) [CC BY 2.0], via Wikimedia Commons.

The MSc in Palliative Care is run in partnership with Queen Margaret University and is designed for experienced practitioners from all disciplines involved in the care of patients and their families in the palliative care phase of illness. It is an interdisciplinary programme that has been designed for maximum flexibility. Students can do single modules for continuing professional development, four specialist modules for the Post Graduate Certificate or eight modules for the Post Graduate Diploma. Eight modules and the work based dissertation leads to the MSc in Palliative Care.

Also run in partnership with Queen Margaret University is The Graduate Certificate in Palliative Care, again designed to provide a flexible approach to study. It consists of three 20 point degree level modules and can be undertaken by students with or without a degree. The Graduate Certificate is achieved by completion of the three modules. The modules can also be accessed and used for degree completion or individual modules can be accessed for Continuing Professional Development.

Further information about either of the above programmes of study can be obtained from:

  • Janice Logan, Programme Leader MSc in Palliative Care and Graduate Certificate in Palliative Care
  • Tel: 0131 551 7710
  • Email: jlogan@stcolumbashospice.org.uk

In addition PATCH will be discussing with St Columba’s Hospice how we can further support any modules tailored specifically for staff working in hospital.