Better Conversations – Better Care : Evaluation of Training within the Serious Illness Care Programme UK


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Anita Roberts1,Alison Coakley2,Helen Bonwick3,Andrew Khodabukus4,Susan Block5,Justin Sanders5,Francine Maloney5,Jo Paladino5,Tamsin McGlinchey1,Maria Maguire2,Stephen Mason1,Peter Kirkbride2,John Ellershaw1
1University of Liverpool,2Clatterbridge Cancer Centre,3Marie Curie Cancer Care,44Royal Liverpool and Broadgreen University Hospitals NHS Trust,5Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Ariadne Labs, Boston, MA

Abstract

Background

The Serious Illness Care Programme UK involves meaningful conversations between doctor and patients with serious illnesses to identify what matters most to the patient, their goals and their priorities. It is based on an approach developed by a team led by Atul Gawande at Ariadne Labs in the USA.

Method

Training was aimed at GPs and Oncologists working in 3 pilot sites in the UK. It consisted of a 6 hour study day followed by a coaching programme. It included background to and overview of the Serious Illness Programme UK and the Conversation Guide. It also included opportunity for each participant to practice using the Guide with a simulated patient and documenting the discussion. The training was run on 6 occasions in a cancer centre and 2 CCGs involved in the pilot. Following the training, each Clinician was invited to participate in a coaching programme. Evaluation included pre & post course questionnaires & a clinician acceptability questionnaire.

Results

57 participants completed the training: 19 Consultant Oncologists, 1 Consultant Haematologist, 3 Palliative Medicine Consultants doctors, 36 GPs. Initial analysis suggests that participants were overwhelmingly positive about the course. In depth analysis is currently being undertaken and includes: change in perceived level of skill pre and post training, the extent that training met objectives & level of importance of the components of the training. In addition, the number of Serious Illness conversations undertaken by each participant and the level of engagement in the coaching programme for 6 months following the training will be reported.

Conclusion

Clinicians who completed the training went on to use the Serious Illness Conversation Guide and take part in the coaching programme. Though the sample for this evaluation was small, the training and coaching were valued by participants and prepared clinicians effectively. Further roll out of the UK programme is planned.