Our Advance Care Planning workshop
Why the workshop was developed
This workshop is based on the SAGE & THYME structure. It was developed in 2011 by staff working for Lancashire and South Cumbria Cancer Services Network (LSCCN). At the time, LSCCN offered SAGE & THYME Foundation Level workshops across the locality, to all health and social care staff in all care settings. Requests were being made for the workshop to focus on advance care planning for GPs.
As the skills and structure of the SAGE & THYME model are transferable, the Foundation Level workshop was adapted to focus on the particularly challenging consultations that address advance care planning (ACP) and end of life issues.
In 2012, University Hospital of South Manchester NHS Foundation Trust (UHSM - now MFT) began to collaborate with LSCCN to refine the SAGE & THYME ACP workshop. Since then, it has been run for many organisations.
The SAGE & THYME ACP workshop lasts for 3.5 hours, is run by 3 facilitators, and can be attended by up to 30 participants. It uses a combination of a lecture, small group work and interactive rehearsals of the conversation.
During the workshop learners focus on effective communication skills that help open an advance care planning conversation. The structure provides a consultation guide as concerns and issues are disclosed.
Note that the workshop does NOT cover: breaking bad news; Mental Capacity Act; or specific documents such as ‘preferred priorities of care’.
The SAGE & THYME ACP workshop has been delivered to a number of GPs, community nurses, acute and out-of-hours staff who are responsible for advance care planning. The participants’ feedback has demonstrated that they have an increased confidence in starting an end of life care or advance care planning conversation, and in responding to a patient’s or relative’s concerns during the conversation. They also rate their competence in conducting such a conversation more highly after the workshop.
The workshop is suitable for senior staff who would engage in advance care planning/end of life care discussions with patients and relatives in the course of their role (working at level 2 of the four level NICE communication model1).
The course was professionally and effectively run by experienced facilitators. It was well pitched with a supportive style of facilitation. Practitioners report that the structure is really helpful for day-to-day practice with people approaching the end of their life.
I feel relieved that I now have more confidence to embark on end of life conversations.
I was surprised that by letting the patient talk through things they seem more clear and definite of what they want/don’t want by the end of the conversation.
You don’t always need to fix problems! Gathering, acknowledging concerns and allowing patients to discover a solution is the way to go.
Even if you feel experienced in ACP this course is absolutely invaluable. It certainly helped me to re think and improve personal practice and support others within our organisation. Thank you.
An evaluation of the workshops with over 400 participants has been carried out:
- The workshop significantly increased from pre to post workshop: staff confidence in starting a conversation about advance care planning or end of life care and also in responding to concerns raised during such a conversation.
- Participants also showed a significant increase in perceived confidence in conducting an advance care planning/end of life care conversation.
- 74% of participants said they would definitely change their practice as a result of the workshop.
- 88% of participants would definitely recommend the workshop to others.