Background Good communication skills are fundamental to the care that we give to patients and families. In line with the ‘End of life care core skills education and training framework’ (Skills for Health & Skills for Care, 2017) all three Tiers of communication skills were piloted in a blended approach, to be accessible to all and with the ability to enhance confidence and embed skills across the multiprofessional community workforce. This included Tier 1 (incorporating advance care planning/LISTEN (Watson, Hembrow. BMJ Support Palliat Care. 2019: 129:A55-A56)), Tier 2 (enhanced courageous conversations) and Tier 3 (advanced communication skills training).

Aim Funding supported by ICB for three pilots, to establish uptake to differing staff groups, with evaluation to measure impact on confidence and competence in practice using East Midlands Evaluation Tool (Whittaker, Parry, Bird, et al. BMJ Support Palliat Care. 2018; 8(4);439–446). Assumptions and misconceptions within communication skills lead to lack of confidence and barriers in effective communication (Royal College Physicians. Talking about dying 2021: How to begin honest conversations about what lies ahead. RCP; 2021). Effective training has been shown to enhance professional behaviours and improve confidence/competence in initiating end of life care conversations with compassion.

Method

• 100 places for Tier 1, three hour communication skills, 3 x workshops online and 2 face–to–face, target all staff groups health and social care.

• 100 places Tier 2, full day communication skills, 3 x workshops online and 2 face–to–face target clinical staff.

• 50 places Tier 3, two day workshops all face–to–face, target GPs and End of Life Care Leads.

Results Delivery of Tier 1 and 2 evaluated with growth in confidence and competence equally whether delivered face-to-face or online. Tier 3 remains face-to-face, practice and feedback are both essential for ongoing development within competence and confidence building (Norman, Lotrecchiano. J Clin Transl Sci. 2021;5(1):173).

Conclusion Skill building is essential across all 3 Tiers; communication skills cannot be built by experience alone. Pedagogy of teaching approaches to further provide opportunities to embed and equip by labeling micro skills and role modeling skills of empathy are successful.