About the Framework

The Framework promotes a consistent, inclusive and flexible approach to learning and development in end-of-life and palliative care for service providers. Varying levels of knowledge, experience and skills that all health professionals and staff bring to practice is acknowledged within the Framework.

The place of both informal and formal learning to develop knowledge and skills within the workforce is recognised and it is the intention that the Framework complement existing sector and discipline specific standards and frameworks.

The Framework supports the education and training of health professionals and staff in end-of-life and palliative care by:

  • guiding the identification of current knowledge, skills and experience
  • clarifying future education and training needs
  • guiding the acquisition and/or development of required education and training.

Users of the Framework will:

  • work through the three domains, review the associated learning items to determine the existing level of knowledge and expertise of the individual/group requiring training
  • identify gaps in knowledge and skills for the individuals/group requiring training
  • identify education and training required, by topic and expertise level (foundation, consolidation and extension).
Development of the Framework

The End-of-Life Care Program, Health Networks, has developed the Framework in collaboration with key stakeholders, in response to the issues regarding education and training for end-of-life and palliative care highlighted in the following reports:

  • The Sustainable Health Review: Final Report to the Western Australian Government 2019
  • The West Australian End-of-Life and Palliative Care Strategy 2018–2028
  • My Life, My Choice: The Report of the Joint Select Committee on End-of-Life Choices 2018.

The key messages relating to education and training presented in these documents include:

  • West Australians are supported to achieve respectful and appropriate end-of-life care and choices
  • all health professionals caring for a person at end-of-life are prepared and able, to provide confident, sensitive, and skilful care before, during and after death
  • health professionals and staff require access to ongoing comprehensive and practical education and training, in order to provide appropriate end-of-life and palliative care.

The role of quality education and training in building service provision capacity has been a longstanding focus of the end-of-life and palliative care sector.

Acknowledgement is given to the considerable body of work done by the sector in this area that has led to the development of this Framework.

The National Palliative Care Standards, 5th Edition 2018, has been developed for use by specialist palliative care service providers to support the delivery of high-quality palliative care for the person receiving care, their family and carers. The nine standards are divided into two categories:

  • Care Standards (Standard 1–6), which describe the systems and enablers necessary to deliver high quality clinical care.
  • Governance Standards (Standards 7–9), which describe the expectation in regard to quality management, quality improvement and bench-marking.

The Framework will assist organisations to align service provision with the National Palliative Care Standards by addressing Standard 9, “Staff and volunteers are appropriately qualified, are engaged in continuing professional development and are supported in their roles”. The applicable National Standards are identified within the Framework domains. The National Palliative Care Standards, 5th Edition 2018, can be viewed on the Palliative Care website (external site).

The National Palliative Care Standards 5th Edition 2018

Standard 1

Staff and volunteers are appropriately qualified, are engaged in continuing professional development and are supported in their roles.

Standard 2

The person, their family and carers work in partnership with the team to communicate, plan, set goals of care and support informed decisions about the care plan.

Standard 3

The person’s family and carers needs are assessed and directly inform provision of appropriate support and guidance about their role.

Standard 4

Staff and volunteers are appropriately qualified, are engaged in continuing professional development and are supported in their roles.

Standard 5

Care is integrated across the person’s experience to ensure seamless transitions within and between services.

Standard 6

Families and carers have access to bereavement support services and are provided with information about loss and grief.

Standard 7

The service has a philosophy, values, culture, structure and environment that supports the delivery of person-centred palliative care and end-of-life care

Standard 8

Services are engaged in quality improvement and research to improve service provision and development.

Standard 9

Staff and volunteers are appropriately qualified, are engaged in continuing professional development and are supported in their roles.
Acknowledgements

We gratefully acknowledge the significant time and expertise generously given by the individuals listed below to the creation of the Framework.

Grace Buchanan
Manager, Palliative and Support Care Education Service, Cancer Council WA

Elissa Campbell
Palliative Care Physician/Gerontologist, President Palliative Care WA

Valerie Colgan
Nurse Educator, Palliative Care, WA Cancer and Palliative Care Network (WACPCN) Clinical Implementation Unit

Jacquie Garton-Smith
Hospital Liaison GP/Clinical Lead Primary Care Integration, Health Networks

Ed Gaudoin
(Formerly) Clinical Nurse Coordinator, Metropolitan Palliative Care Consultancy Service (MPaCCS)

Tish Morrison
(Formerly) Director or Palliative and End-of-life Care, Silver Chain

Alison Parr
WA Cancer and Palliative Care Network (WACPCN) Clinical Lead, Palliative Care

Sumit Sinha-Roy
Deputy Director Clinical Services, Royal Perth Hospital

Simon Towler
WA Cancer and Palliative Care Network (WACPCN) Clinical Lead, End-of-life Care

Penny Tuffin
Advance Practice Pharmacist, Royal Perth Hospital, Fiona Stanley Hospital, Bethesda Hospital

We gratefully acknowledge the expert contributions made by:

Lisa Cuddeford
Clinical Lead, WA Paediatric Palliative Care Service, Perth Children’s Hospital

Lauren Breen
Associate Professor, Director of Graduate Research, School of Psychology, Curtin University

The Framework builds on the 2015 End-of-Life and Palliative Care Learning Continuum created by the WACPCN, End-of-Life and Palliative Care Education Working Group 2012 – 2014, in addition to the longstanding and ongoing collective contribution of the sector.
References
  1. Western Australian Department of Health. Sustainable Health Review: Final Report to the West Australian Government. Perth: Sustainable Health Review; 2019. https://ww2.health.wa.gov.au/Improving-WA-Health/Sustainable-health-review/Final-report
  2. Western Australian Department of Health. Western Australian End-of-Life and Palliative Care Strategy 2018-2028. Perth: Western Australian Cancer and Palliative Care Network; 2018. https://ww2.health.wa.gov.au/-/media/Files/Corporate/general-documents/Health-Networks/Palliative-care/WA-End-of-life-and-Palliative-Care-Strategy-2018-2028.ashx
  3. Joint Select Committee on End-of-Life Choices. My Life, My Choice – The Report of the Joint Select Committee on End-of-Life Choices. Perth: Parliament of Western Australia; 2018. https://ww2.health.wa.gov.au/Articles/J_M/Joint-Select-Committee-on-End-of-Life-Choices-Report-My-Life-My-Choice
  4. Palliative Care Australia 2018, National Palliative Care Standards 5th edn, PCA, Canberra.
  5. The Institute for Patient- and Family-Centred Care [Internet]. What is patient- and family-centred health care? Bethesda, MD: IPFCC [updated 2010 Dec 29; cited 2014 Feb]. https://www.ipfcc.org 
  6. Clayton J, Hancock K, Butow P, MHN T, Currow D. Clinical practice guidelines for communicating prognosis and end-of-life issues with adults in the advanced stages of a life-limiting illness, and their caregivers. Medical Journal of Australia. 2007;186(12): S77-108.
  7. Australian Commission on Safety and Quality in Health Care. National Safety and Quality Health Service Standards. 2nd ed. Sydney: ACSQHC; 2017.
  8. Australian Government Aged Care Quality and Safety Commission. Quality Standards. [Internet]. The Aged Care Quality and Safety Commission. 2019. [Cited 9 June 2020]. https://www.agedcarequality.gov.au/providers/standards
  9. Australian Government Department of Social Services. National Standards for Disability Services. [Internet]. 2013. [Cited 9 June 2020]. https://www.dss.gov.au/sites/default/files/documents/06_2015/nsds_full_versin.pdf
  10. Australian Commission on Safety and Quality in Health Care. National Safety and Quality Primary Health Care (NSQPHC) Standards [Internet]. [Cited 9 June 2020]. https://www.safetyandquality.gov.au/standards/national-safety-and-quality-primary-health-care-nsqphc-standards
  11. Government of Western Australia Department of Health. Goals of Care in the COVID-19 environment. [Internet] 2020. [Cited 1 July 2020]. https://ww2.health.wa.gov.au/Articles/F_I/Goals-of-patient-care 
  12. Pfaff, K., Markaki, A. Compassionate collaborative care: an integrative review of quality indicators in end-of-life care. BMC Palliat Care 2017;16: 65. https://doi.org/10.1186/s12904-017-0246-4
  13. Western Australian Department of Health, 2020. Advance Care Planning: A Patient’s Guide, Perth: WA Cancer and Palliative Care Network, Department of Health, Western Australia.
  14. L Chambers. A Guide to Children’s Palliative Care (Fourth Edition). [Internet]. Bristol: Together for Short Lives; 2018 [cited 12 August 2020]. https://www.togetherforshortlives.org.uk/resource/a-guide-to-childrens-palliative-care