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Competencies for good end of life care laid out in new national framework

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The key knowledge and competences required by staff who provide end of life care have been drawn together in a new national training framework.

The document, commissioned by Health Education England, is designed to ensure “tailored, high-quality care and support” to patients with advanced incurable illness and, and also to their families.

“Health and social care staff have the opportunity to make a positive difference to the experience of people who are at the end of their life”

John Rogers

It sets out the different levels of training required depending on the amount of contact professionals have with adult patients requiring this type of care.

Those behind the framework – drawn up in collaboration with training organisations Skills for Health and Skills of Care – said it would enable organisations, service providers and clinical teams to benchmark their own standards, identify areas they needed to improve and take steps to address them.

They said it was based on the principles of person-centred care, which meant the patient’s individual needs should be considered and that they and their families should be involved in care decisions.

To achieve this, the document – called the End of Life Care Core Skills Education and Training Framework – promotes greater collaboration between organisations in the health and care sectors and in the community, they said.

It is based around 14 areas, including how to communicate with families and have “difficult” conversations, as well as the practical and emotional support that can be offered to people nearing the end of life.

“This easy-to-use framework supports social care and health workers to understand the key issues around good end of life care”

Sharon Allen 

Assessment and care planning, symptom management, legal considerations, and care after death also feature.

Skills for Health chief executive John Rogers said: “Health and social care staff have the opportunity to make a positive difference to the experience of people who are at the end of their life, their families and carers; not just through palliative treatment but also through emotional support.

“This can be a rewarding but also demanding experience, requiring a diverse mixture of technical skills, knowledge, compassion and resilience,” he said. “It is vital that staff are equipped to meet these expectations.

“This new framework will consolidate, clarify and benchmark the key knowledge and competences staff at all levels need to provide patients and their families with the very best support and care at this vulnerable time,” he added.

Skills for Care chief executive Sharon Allen said: “High-quality end of life care that supports people’s needs, as well as their family and support networks, is something everyone has an absolute right to expect.

“This easy-to-use framework supports social care and health workers to understand the key issues around good end of life care to make sure they can provide quality care and support when the person they are working with needs it the most,” she stated.

wendy reid

wendy reid

Wendy Reid

Professor Wendy Reid, director of education and quality at HEE, added: “We recognise the importance of a wide range of skills in those looking after patients at the end of their lives.

“This framework will help organisations provide appropriate education and training that equips teams with the skills, knowledge and confidence needed to deliver high quality, person centred, end of life care,” she said.

The framework coincides with the publication of new palliative care standards by the National Institute for Health and Care Excellence that focus on the need to ask patients near the end of their lives about their wishes and any spiritual beliefs.

Adults in the last days of life, and the people important to them, should be given opportunities to discuss the care they want to receive, stated NICE, as part of efforts to improve patient choice.

But both documents also follow concerns being raised this week over the consistency of how palliative care is provided across England. Experts said palliative and end of life care were not being considered as core services by some clinical commissioning groups, with a vast degree of variation across different services and regions.

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