Background Advance Care Planning is a process of discussion with individuals about their wishes and preferences regarding the type of care they would wish to receive or refuse in the future, should they lack capacity at that time. These discussions need to be handled with sensitivity and skill, the outcomes documented and reviewed regularly, and communicated to other relevant people with the individual's consent. The recognition of the importance of Advance Care Planning has been highlighted by the National End of Life Care Programme. As a UK tertiary cancer centre serving a population of 2.3 million, the implementation of Advance Care Planning produced significant and unique challenges.
Aim To introduce Advance Care Planning into a tertiary cancer centre.
Method Education was delivered to all health care professionals in both formal and informal sessions, including 'drop in' sessions provided over a whole day. Resource folders were introduced into all wards, containing written information for staff, and localised information and documentations for patients.
Results There was good attendance from staff across the organisation and the formal sessions stimulated much discussion especially regarding the role of a tertiary centre. These discussions included the inherent difficulties involved in liaising with a range of health care professionals across the region. There are multiple Health Care Teams in the Network, all of whom are at different stages of implementing Advance Care Planning for their patients. It was agreed that sensitive communication with the patient was of the utmost importance, with some staff admitting their lack of confidence in this area.
Conclusions The introduction of Advanced Care Planning into a tertiary cancer centre is a challenge due to the wide geographical area. Further education sessions are planned including an intermediate experiential two-day communication skills training course to help staff required to initiate sensitive discussions with patients.
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