Learning programme · #P9
A ten-module programme on recognising deterioration, communication, planning, symptom care, treatment decisions and care in the last phase of life.
Healthcare professionals providing generalist palliative and end-of-life care to adults.
Certificate process: Integrated final assessment + optional private reflection + course completion certificate
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Palliative care should be understood as an active approach to improving quality of life and reducing suffering for people living with serious or life-shortening conditions. It is not a declaration that disease-directed treatment has ended. Scottish national strategy now explicitly describes palliative care as helping people live as well as possible with...
NICE NG142 recommends systems to identify adults who may be approaching the end of life so that planning, support and coordination can begin. Identification may be prompted by progressive functional decline, increasing frailty, recurrent unplanned admissions, escalating symptom burden, weight loss or reduced intake, disease-specific deterioration, or...
Advance or future care planning is a voluntary process of thinking and talking about what matters now and what may matter if health changes. NHS England Universal Principles, NHS Wales Future Care Planning and Northern Ireland's policy all emphasise person-centred reflection rather than form completion. The terminology differs, but the underlying aim is...
Serious illness can impair decision-making temporarily through delirium, fatigue, breathlessness, pain, medication effects or communication difficulty. Before concluding that a person cannot decide, clinicians should take practicable steps to support participation where time allows: treat reversible distress, choose a better time, simplify information,...
Goals-of-care discussions should connect the person's priorities with what medicine can realistically achieve. The conversation asks which outcomes matter, what burdens are acceptable, which treatments are clinically appropriate and what should happen in an emergency. The product should be a positive care plan, not only a list of interventions that will...
Anticipatory medicines are prescribed in advance so that symptoms can be treated promptly if they arise, particularly when access to prescribing may be difficult out of hours. NICE recommends an individualised approach, with clear indications and routes, and requires assessment before administration. The presence of a 'just in case' medicine does not...
Reduced appetite and fluid intake are common as dying approaches. This does not remove the duty to offer assistance with eating and drinking where wanted and appropriate. NICE recommends supporting a dying person to drink if they wish and are able, checking swallowing safety, providing frequent mouth and lip care, and helping with sips where appropriate....
The central lesson from NICE NG31 is individualisation. Once a person may be entering the last days of life, the team should communicate the uncertainty, identify what matters, assess symptoms and hydration, review medicines and interventions, and keep the plan under active review. A standard form can improve reliability, but it must not replace clinical...
Statements such as 'I cannot go on' or 'I want this to end' can mean many different things: uncontrolled pain, fear of future dependency, depression, existential distress, a wish to stop burdensome treatment, a capacitous refusal, or a request for help to end life. The first clinical duty is to listen and clarify rather than label the request...
The moment of death changes the clinical task but does not end professional responsibility. Immediate care includes dignity and privacy, respectful care of the body, support for family and others present, attention to religious or cultural wishes where possible, safe management of devices and property, and clear explanation of what will happen next....
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