Development of an knowledge and skills Development Framework for Palliative and End of Life Care for the Health and Social Services Workforce

Learning and Development Framework Knowledge and Skills Learning and Development Framework Health and Social Services Workforce in Scotland Palliative and End of Life Care

Aim and Outline To raise awareness of the education and development framework. Introduction ppt, context, development stages Draft framework for consultation : Communication Domain Questions and answers

Palliative and End of life Care in Scotland 40,000 0f 54,000 people who die each year need palliative care. However, 11,000 people miss out on that care People receive 90% of their care at home/homely setting in the last 6 months of life Between 50-75% of people express a preference to die at home – yet only 25% do.

A Growing Challenge Ageing population – over 75s due to increase by 85% by 2039 People dying by 2037 to increase by 12% to 62,000 Increasing complexity – nearly 2/3rd of people over 60 have a long term condition 40% of people aged 75 or over living with two or more long term conditions The shift from acute care to community – increase in demand to die at home? Less resources available to meet the challenge 8 out of 10 people who die have needs that could be met through palliative care

A Growing Challenge Next 20 years – estimated demand for health and social care services will increase by 20-30% 168,526 bed days lost to delayed discharge (oct- Dec 2014) 96% of bed days associated with delayed discharge responsibility of health and social care partnerships Over 50% of all expenditure for over 65’s was within a hospital setting – vast majority was unplanned admissions (61.7%)

Strategic Framework for Action on Palliative End of Life Care Meeting the Challenge Vision By 2021, everyone in Scotland who needs palliative care will have access to it Commitment 3 “ We will support the workforce by commissioning NHS Education for Scotland and Scottish Social Services Council to develop a new palliative and end of life care Educational Framework. This will address the needs of the whole workforce and will focus on fostering an integrated and collaborative approach to educational provision.”

Strategic Framework for Action on Palliative Care and End of Life Care Collaboration and Co-operation

Development of Strategic Framework for Palliative and End of life Care Communication Pathways and Quality/Development Monitoring National Advisory Group –and Stakeholder Group (2015) ↕ National Implementation Group (2016-2018)

The Strategic framework identifies 10 commitments with one commitment specifically focused on education, learning and training: “We will support the workforce by commissioning NHS Education for Scotland and the Scottish Social Services Council to develop a new palliative and end of life care Educational Framework. This will address the needs of the whole workforce and will be focused on fostering an integrated and collaborative approach to educational provision.” A workforce that feels adequately trained and supported to provide the palliative and end of life care that is needed. All health and care workers require an appropriate level of knowledge and skill in palliative care and end of life to match level of involvement with people with P&EoLC needs

Palliative and End of Life Care Knowledge and skills Development Framework The framework will support the workforce to develop the knowledge , skills and behaviours to enable them to deliver high quality palliative and end of life care in the way that matters to individuals , their families and carers.

Development of an Education and Development Framework for Palliative and End of Life Care for the Health and Social Services Workforce NES appointed 3 Practice Development Co-ordinators(PEC) The PEC’s will be in place to support the development and implementation of the framework . WEST (base Glasgow) : Elizabeth Sanchez-Vivar NORTH (base Dundee) : Jane Andrew SOUTH/EAST (base Edinburgh) : Elaine Colville

Communication Pathway for Development and Governance Monitoring Project Development of National Education Framework for Palliative and End of life Care Communication Pathway for Development and Governance Monitoring National Implementation Advisory Group(Scot Govt, Heath, Social Services, stakeholders ) ↕ Education Advisory Group( NES, SSSC, External) Project Team(NES,SSSC) NHS and Social Care Workforce

Development of National Education Framework for Palliative and End of life Care Project Development to date Project Team Engagement with health, public, third and independent sectors, and education providers. HSCP, Integration Leads, Commissioner’s. Community of Practice (Knowledge Network - NES) Focus Groups 10 in Total Jan - July 2016 key themes identified Learning Needs Survey Aug-0ct 2016 3500 responses - Analysis Nov/Dec Expert Virtual Groups Special Reference Opinion Groups eg SCYPPX, Specialist PC, Carer’s. LD/MH. Social Services Regional Consultation Events 1st Draft Framework Jan 2016 1st Feb Launch Consultation draft Framework

Structure of Framework The framework has three interrelated components: Principles of the framework Domains and associated knowledge and skills Levels of practice

Knowledge and Skills Development Framework for Health and Social Care Workforce in Scotland Fundamental K + S DOMAIN 1 Communication & Conversation DOMAIN 2 Love, Grief and Bereavement K + S DOMAIN 3 Care Planning - K + S DOMAIN 4 Care Last Days of Life - K + S DOMAIN 5 LEVEL Expert LEVEL Enhanced LEVEL Skilled LEVEL Informed UNDERPINNING Human Rights Person-centered Care National Care Standards PRINCIPLES

Context (foundations) World Health Organisation definition of Palliative Care Scottish National Action Plan on Human Rights (SNAP) New National Care Standards for Health and Social Care Services National Health and Wellbeing Outcomes National Clinical Strategy for Scotland Vision and Strategy for Social Services in Scotland WHO definition of palliative care endorsed by the Scottish Government Palliative care recognised by the WHO as a human right Human rights are the rights and freedoms that belong to every person at every age. These rights are set out in laws which help to raise everyone's awareness of the need to uphold individual rights and protect people with protected characteristics from discrimination Scottish national action plan on human rights The model which SNAP promotes is a “human rights based approach” which emphasises participation, accountability, non-discrimination, empowerment and legality (“PANEL”). These principles help us to help us to provide person centred service and help good decision We also the National Health and Wellbeing Outcomes are high-level statements of what health and social care partners are attempting to achieve through integration and ultimately through the pursuit of quality improvement across health and social care. The national clinical strategy and the vision and strategy for social service also help us look to the future and the opportunities to work differently and better and to improve the outcomes that are important for people and reduce inequalities.

Draft framework levels (adapted from Promoting Excellence dementia framework) Each level defines the knowledge, skills and behaviours specific to the worker’s role in relation to palliative and end of life care. Rather than being hierarchical the levels are concerned with levels of responsibility in relation to working with people with palliative care needs which will vary greatly across organisations and sectors. Each level defines the knowledge, skills and behaviours specific to the worker’s role in relation to palliative and end of life care. Rather than being hierarchical the levels are concerned with levels of responsibility in relation to working with people with people with palliative care needs which will vary greatly across organisations and sectors. Each level defines the expertise specific to their role in relation to palliative and end of life care that a worker must have, rather than in relation to their seniority within the organisation or their profession. Proposed levels

Draft framework levels Informed practice level : Outlines the baseline knowledge and skills in relation to palliative and end of life care required by all health and social service workers Skilled practice level: Outlines the knowledge and skills required by health and social service workers who by virtue of their role and level of responsibility regularly provide care and support to people with palliative and end of life care needs, their families and carers. Enhanced practice level: Outlines the knowledge and skills required by health and social care service workers who by virtue of their role and level of responsibility provide, co-ordinate and manage the care and support of people with palliative and end of life care needs, their families and carers. Expert practice level : Outlines the knowledge and skills required by health and social service workers who by virtue of their role and level of responsibility play an expert specialist role in the care and support of people with palliative and end of life care needs, their families and carers.

Proposed Domain Themes Fundamentals of palliative and end of life care Communication and conversations Loss, grief and bereavement Care planning and delivery Care in the last days of life Our Framework Knowledge and skills that are required to provide person centred palliative and end of life care Five domains identified We will ask for your thoughts about these themes as a way of structuring the framework

Knowledge and skill Domains Loss, Grief & Bereavement Fundamentals Of Palliative Care Communication & Conversations Care Planning Care in last days of Life

Phase1 : Development Framework Development and Production CONSTRUCTION OF DRAFT FRAMEWORK CONTENT ENGAGEMENT WITH STAEKOLDERS CONSULTATION WITH STAKEHOLDERS REVIEW OF THE DRAFT FRAMEWORK REVISION OF THE DRAFT FRAMEWORK

Domain Communication and Conversations LEVELS Informed Skilled Enhanced Expertise Communication and Conversations

Ongoing and Future development Phase 2 National Knowledge and Skills Development Framework PEoLC Launch provisionally April 2017) National and Regional Engagement for Implementation with Health and Social Care Partnerships, Independent, Third and Education Sector Work Force National and Regional Engagement for Evaluation and Impact Assessment Continuous Regional Engagement with Health and Social Care Partnerships, Independent, Third, Education sector work force (identify educational need, gaps, resources, access to education/training) Review, update and collate existing educational resources (nationally , regionally and internal)

National Consultation Draft Framework Now Live !!!!! The framework and survey can be accessed through the following link: http://www.knowledge.scot.nhs.uk/media/CLT/Resourc eUploads/4081668/5c88d2b3-f150-423a-a8a4- a44e9dd549e0.pdf   Survey responses may be made on behalf of a group or organisation or as an individual. The consultation will close on the 20th of February 2017.