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BackgroundIn July 2013 an Independent Review of the Liverpool Care Pathway (LCP) recommended that it should be phased out and replaced by an individual end of life care plan. The review emphasised the need for robust education for clinicians involved in caring for dying patients. It is therefore crucial we understand how staff review the education they receive on the LCP.AimTo evaluate clinical staff's views on education they receive on the LCP.MethodTwo wards in Gateshead Health NHS Foundation Trust were randomly chosen. In June 2013, all their staff were invited to complete an anonymous survey. Currently, end of life training is not mandatory and staff access education as per their needs.ResultsCurrent training47% of clinical staff responded. 31% were confident they had received training on using the LCP. 46% of respondents felt they were confident in using the LCP.Future Training51% of respondents felt that the LCP should be part of mandatory training. 63% would access further training if available.LimitationsOur results are based on less than 50% response to the survey and may therefore not represent the full views of all staff.DiscussionOur survey shows that the majority of staff are not confident in the use of the LCP. This may reflect lack of training but also lack of clarity around what education staff may need for caring for dying patients.In contrast, clinical staff are clearly keen to improve their knowledge and feel a need for mandatory end of life training.ConclusionThis survey has shown that clinicians perceive a lack of education around the use of the LCP. This will need to be addressed in order to build a confident and competent end of life care workforce.

BackgroundOver the last year, concerns have been raised about the care of patients on the Liverpool Care Pathway (LCP). In July 2013 an Independent Review recommended that the LCP should be phased out and replaced by an individual end of life care plan. It is crucial we have an understanding of how clinical staff perceive the LCP to develop robust training around end of life care.AimTo evaluate clinical staff's perceptions regarding the LCP.MethodTwo wards in Gateshead Health NHS Foundation Trust were randomly chosen. In June 2013, all their staff were invited to complete an anonymous survey.ResultsGeneral Views47% of clinical staff responded. 57% thought the LCP should only be used in the last 48 hours of life. 94% felt the LCP ensures patients are treated with respect. Only 1 staff member felt that the LCP speeds up dying.Care whilst on LCP71% of clinical staff felt that they would consider treatments depending on the clinical situation. 80% would regularly monitor patients with 94% checking for signs of improvement. 86% would stop the LCP if the patient recovered.LimitationsOur results are based on less than 50% response to the survey and may therefore not represent the full views of all staff.Discussion57% of staff can recognise when to commence the LCP. Once in use, a majority of staff are able to decide on treatments and monitoring. Confusion can however arise if all are not clear of the application of the LCP. This can lead to some of the issues raised in the Independent Review.ConclusionThis survey has shown that clinical staff know when and how to apply the LCP. End of life training needs to continue to support staff in this.

Background Peer and near-peer teaching is now a recognised approach in medical undergraduate education with increasing evidence to support its efficacy. Aims (1) To establish a teaching day delivered by palliative care trainees for doctors-in-training in other specialties. (2) To show that trainees in palliative medicine are effective near-peer and peer-led tutors. (3) To demonstrate impact of teaching day on learners' knowledge and confidence. Methods A programme was designed to cover core palliative care topics contained within the curricula of other specialties. Participants completed a pre and postcourse questionnaire of clinical scenarios to survey their knowledge and confidence; and a satisfaction questionnaire. Results Thirty-five doctors attended the teaching day. Confidence and knowledge ratings increased at the end of the teaching day. Results of the satisfaction survey were overwhelmingly positive. Limitations This cohort was not fully representative of all doctors in training. Discussion This study does not determine whether there is sustained impact on knowledge and confidence of participants; this could be assessed in future teaching programmes using the same confidence and knowledge questionnaire 8 weeks postcourse. Participants' knowledge and perceived confidence in a learning environment may not translate into clinical ability. Conclusion A teaching day delivered by palliative care trainees for other doctors-in-training, is achievable and positively received. Feedback showed trainees are effective and approachable tutors. There was a demonstrable positive impact on knowledge and confidence immediately following the teaching day. This method of teaching enables both teachers and participants to achieve curriculum objectives. Further research is required to further explore whether peer and near peer teaching is more acceptable and effective than consultant teaching and reasons why this may be so.