Consultation Feedback Form

Consultation Feedback Form Towards Excellence in Palliative Care Draft Self-Assessment Tool December 2012

We would like to get your feedback on the draft “Towards Excellence in Palliative Care Draft Self-Assessment Tool”.

The National Palliative Care Clinical Programme will consider your feedback and use it to inform the development of the self-assessment tool.

The closing date for this consultation and receipt of feedback is 16 January 2012.

Please note that the HSE is subject to the Freedom of Information Acts and the statutory Code of Practice regarding FOI.

For that reason, it would be helpful if you could explain to us if you regard the information you have provided as confidential. If we receive a request for disclosure of the information we will take full account of your explanation, but we cannot give an assurance that confidentiality can be maintained in all circumstances.

About you

Name Dr Michael Connolly

Contact details [email protected]

Organisation All Ireland Institute of Hospice & Palliative Care (AIIHPC) Is this submission made on Organisation Personal behalf of your organisation or X □ in your personal capacity Date January 15th 2012

1 General feedback questions

You may provide us feedback on the specific questions asked below, or alternatively you can provide us with general comments.

Consultation Question 1

Question 1: Do you feel there are benefits in having a national self-assessment tool for specialist palliative care services?

Please comment

AIIHPC welcomes the development of National Self-Assessment Tool for Specialist Palliative Care Services. This development is timely and represents a commitment to measuring and improving practice in light with international developments.

Question 2: Is the layout of the document clear and easy to use, including language and descriptors used?

Please comment

In general the document is laid out in way that is clear and easy to read. The language used in accessible, however the final draft would benefit from proof reading for spelling and grammar.

Providing the Assessment Tables in the Appendix will be helpful to the personnel who will be engaged in the assessment.

2 Question 3: Do you feel that the self-assessment tool will support quality improvement and assist specialist palliative care providers (hospices & homecare teams) in complying with the National Standards for Safer Better Healthcare?

Please comment

AIIHPC considers the tool an appropriate means of supporting and assisting specialist palliative care providers in complying with National Standards for Safer Better Healthcare.

In order to ensure that the process is seen in a positive light – education regarding how to use the tool and its benefits should be provided, ideally using on-line resources such as Podcast or Tutorials.

Question 4: Have all of the appropriate themes been included in the self-assessment tool. If not, what additional information should be added or excluded?

Please comment

AIIHPC accepts that all relevant themes have been included in the self-assessment tool.

Question 5:? Can the examples of verification and rating scale be applied within specialist palliative care services? 3 Please comment

AIIHPC sees that the majority of examples provided can be applied within specialist palliative care services.

General Comments

Please provide any general feedback you wish to give below.

Please comment

AIIHPC welcomes the development of National Self-Assessment Tool for Specialist Palliative Care Services, and will serve to ensure the implementation of the National Standards for Safer Better Healthcare in specialist palliative care services.

Specific Feedback – Please provide any specific feedback you may have on each of the themes in the self-assessment tool. In your feedback please outline which section you are referring to.

Person Centered Care and Support (theme 1)

4 Please comment

AIIHPC welcomes the focus on the integration of users, carers and families as a means to ensure the service user’s perspective in central to all aspects of care planning and provision. This theme is central to the work of AIIHP which has as one of its cross cutting themes the “Meaningful involvement of users, carers and communities in the development and delivery of palliative care education, research, policy and practice.” The inclusion of users, carers and families will build trust and confidence in the health service and embed key safety guarantees into the service. It will also ensure that processes are in place for the investigation and resolution of any adverse events.

Effective Care and Support (theme 2) Please comment

AIIHPC broadly supports the need for clinical effectiveness is central to ensuring that practice is based on the best available data and evidence. Some comments on individual sections follow.

5.1 Clinical effectiveness Whilst the focus on actively encouraging all health care professionals to be involved in research and audit projects the verification example (5.1.3) given appears overly ambitious.

5.1.3 Clinical Staff are actively participating in research activity It may not be practical for all clinical staff to be participating in research activity rather all health and social care professionals should be using research and evidence in their practice.

5.3.1 Guidance Clinical audit should be integrated into all healthcare professional education and training curricula (DoHC 2008, p.162). Is there a system in place that can monitor if this type of training is incorporated into curricula for health and social care professional’s?

5.6 Ethics Organisations must operate within an ethical framework that meets the needs of a service but also respects the values of the service user and the service provider and does not compromise ethical responsibilities

AIIHPC welcomes the focus on the importance of ethical care and standards as they relate to practice. However given the number Ethical Frameworks that have been developed and reported in the literature is there a need to provide information on a number of frameworks, from which providers can choose, whilst not being in conflict with organisational ethos.

It is important Advance Care Planning (ACP) not be seen as the primary or only ethical issue in Palliative Care. There is a need for the guidance to clarify that ACP is one issue that may arise and for which an ethical framework can be useful to promote and enable discussion.

5.7 Research 1. Health care professionals need to demonstrate that they are participating in research as appropriate to their roles.

It may not be the case that all health care professionals can demonstrate participation in research. It is more reasonable to suggest that all health and social care professionals maintain research awareness and ensure they continue to practice from an evidence-base, and where possible participate in research.

2. However, organisations and health care professionals need to explore all alternatives that exist to fund 5 research in Ireland.

The term ‘alternatives’ begs the question – alternatives to what? It seems to imply the existence of a regular stream of funding for palliative care research and that health care professionals should seek funding from alternative sources to this.

Rather it may be more appropriate to use the following wording/: However, organisations and health care professionals need to explore all sources of research funding, both national and international, to support and fund palliative care research in Ireland.

Safe Care and Support (theme 3) Please comment

AIIHPC supports the inclusion of this theme which recognises that the safety of service users is paramount.

Better Health & Well-being (theme 4) Please comment

AIIHPC supports the inclusion of this theme which can ensure that palliative care translates the hospice ideals of ‘whole person care’ into broader public health language and practices related to prevention; harm reduction, support, education, and community action.

Governance, Leadership and Management (theme 5) Please comment

AIIHPC supports the inclusion of this theme which supports and fosters a culture of effective governance that drives service user safety and quality and ensures that leadership and leadership skills are supported and developed at all levels in the service.

6 Workforce (theme 6) Please comment

AIIHPC supports the inclusion of this theme which aims to ensure that the workforce is integral to the delivery of a high quality, person centred and safe service.

9.3 Credentialing 9.3.2 There is yearly verification of nurse registration certificate in the service It may be necessary to reword in light of legislation which enables CORU to establish registers for health and social care professionals Suggested wording: There is yearly verification of registration certificate from statutory regulatory body

9.6 Competency Assurance An Bord Altranais – change to An Bord Altranais agus Cnáimhseachais na hÉireann in light of new legislation

Use of Resources (theme 7) Please comment

AIIHPC supports the inclusion of this theme which recognises that the effective responsible stewardship of resources including decisions and how they are allocated is a fundamental factor in delivering high quality safe and reliable care and support.

Use of Information (theme 8) Please comment

AIIHPC supports the inclusion of this theme which recognises that information is at the heart of understanding and knowledge. It is also ensures that accurate, meaningful and accessible information is available to assist staff, management and service users in improving the safety and quality of the service provided.

Thank you for taking the time to give us your views.

Please return your form to us either by email or post: [email protected]

7 If you have any questions on the draft document, please contact Brian Lee, National Programme Manager, by calling (01) 6698805 or email [email protected]