HEE (East Midlands) Foundation School - Trent - END OF LIFE CARE TRAINING

The 2021 Foundation curriculum describes Specific Areas of Core Learning to include 'The dying patient':

All Foundation Doctors should understand the principles of compassionate care of the dying patient and those important to them. Teaching should provide the Foundation Doctor with an approach to managing the last hours of life and introduce the concept of caring for patients who have entered the 'last year of their life'.

Teaching on this topic should align with the six ambitions for palliative and end of life care with emphasis on: • Recognising the dying patient • Sensitive communication including 'talking about death' • Involving and supporting the patient and those important to them • Planning, coordinating and delivering individualised care to maximise comfort and wellbeing.

The course should therefore enable participants to:

• Understand the value of 'diagnosing dying' and estimating life expectancy • Prioritise symptom control as part of end of life care • Describe reasons to refer to specialist palliative care services and how to access local services • Demonstrate an awareness of Advanced Care Planning in end of life care and the times when it may be appropriate • Discuss patients' needs and preferences regarding end of life care wherever possible • Understand the ethics of transplantation and identify potential donors to senior medical staff • Discuss and make plans for preferred place of death wherever possible • Take part in a multidisciplinary approach to end of life of life care utilising end of life care plans and prescribing guidance • Understand the ReSPECT process to record care and treatment preferences. • Understand the importance of appropriate discussion and documentation of Do Not Attempt Cardio-pulmonary Resuscitation (DNACPR) orders • Describe the criteria for issuing DNACPR orders and the level of experience needed to issue them • Discuss DNACPR orders with the multidisciplinary team, the patient, long-term carers (both medical and non-medical) and relatives • Understand the accountability of the responsible clinician when a DNACPR decision is made • Understand the role of the individual and the family in the communication of DNACPR orders • Describe conflicts between patients and their relatives • Describe how to address DNACPR decisions that are challenged/conflicts arise between interested parties • Describe the process of reviewing DNACPR decisions in an end of life care setting • Describe the principles of withdrawing and withholding treatment in end of life care in deciding the ceiling of treatment (Treatment Escalation Plans)

The total contract value is anticipated to be £57,960.00 over the full 2 year contract based on current number of trainees.

The contract period will be for (12) months, with the option to extend for a further (12) months subject to annual review and available budget.