|TARGETED – doctors frequently dealing with palliative care patients i.e. paediatric consultants, A&E doctors community paediatricians, GP’s, ST 3 – 8|
|UNIVERSAL competencies plus||SKILLS AND KNOWLEDGE||TRAINING AVAILABLE|
Ability to identify concerns, break bad news, give complex information, handle difficult questions and manage strong emotions.
Ability to assess and communicate CYP and families’ wishes including preferred place of care and death
Ability to create and review Advance Care Plans actively with CYP and their family
Ability to seek and support the CYP and family wishes regarding organ/tissue donation.
Ability to communicate the individualised plan of care to other key professionals.
|Advanced Communication Skills training.|
|ASSESSMENT and DIAGNOSIS||
Ability to assess, manage and document common physical symptoms encountered in end of life care. Recognise and manage the reversible causes of deterioration.
Ability to assess benefits and burdens of observations and investigations
Ability to identify and manage palliative care emergencies, and refer on if necessary
Ability to contribute to clinical decision making about appropriate intervention/ ceilings of care including decisions about DNACPR
Ability to recognise and manage dying, and diagnose death, including brain stem death
|Local one day course for consultants.|
Ability to continually assess, review and plan care jointly with the CYP and family as appropriate and document accordingly, using ACP if available.
Ability to communicate care plan with multidisciplinary team, including out of hospital.
Ability to recognise the need for and timing of referral to specialist services.
Awareness of local bereavement support services and referral process.
|One day Advance Care Planning course.|
Ability to recognise and manage the physical, psychological, social and spiritual needs of the CYP and their families, respecting ethnic and cultural traditions
Ability to undertake anticipatory prescribing of medications via the appropriate route for specific potential symptoms.
Ability to review medications regularly for current symptoms and manage side effects.
Ability to assess and manage nutrition and hydration needs.
Understanding care of body after death, including spiritual, cultural and religious beliefs. Understanding of processes, role of other agencies and needs of coroner . Ability to signpost if support is needed.
Ability to recognise when personal experiences of death and dying, stress and bias may affect own capacity to deal with the bereaved.
Awareness of the impact of loss and grief, including how to support individuals who are bereaved and identify abnormal grief that may need additional support.