e-ELCA

This new session (10_06) was designed for specialists in palliative care. The session outlines the evidence base and practicalities of Non-invasive ventilation (NIV) for patients. This includes considerations in the withdrawal of NIV. Thanks to Dr David Oliver, Jonathan Palmer, Juliet Colt and Professor Christina Faull for developing this.

It has been written by a multidisciplinary group of cardiology and palliative care specialists to help palliative care clinicians become more confident with managing patients with heart failure and knowing when to liaise with heart failure services. Thanks to Yvonne Millerick, Shona Jenkins, Dr Karen Hogg and Dr Amy Gadoud for developing this.

Module 6 comprises six sessions on Social Care. These have all been updated to ensure their content is relevant and contemporary. The module covers social care issues in both hospital and community settings, as well as how links are made between health and social care. Many thanks to Tes Smith, Director of Quality and Care at Saint Francis Hospice and a real expert in this field, for her work on this.

Session 03_31 Discussing Hydration has been significantly updated. This session was reviewed to align with NICE guideline [NG 31] – Care of dying adults in the last days of life. It is contemporary in content and a useful learning tool for all clinicians looking after patients in the last days of life.

Significant work reviewing the whole of the e-ELCA catalogue has identified a number of sessions that align with elements of the Palliative Medicine Specialty Training Curriculum. This work will soon appear on both the e-ELCA and the APM website, standby for more updates.

This new session (01_06b) complements sessions 01_05 Advance Decisions to Refuse Treatment: Principles and 01_06a Advance Decisions to Refuse Treatment in Practice. It uses four cases studies to help professionals think about how to support patients in the process of creating an advance decision to refuse treatment for different circumstances:

• A current life limiting condition
• Planning for cognitive decline in dementia
• A well patient.

Examples of potential wording are taken from the work of the charity My Living Will. This was quite a challenging session to write and we hope you find it useful.

Thank you to Bridget Taylor for her help with updating “I’m not lovable anymore” – Discussing intimacy in end of life care. Bridget Taylor is an Advanced Nurse Practitioner in Community Palliative Care at Sobell House, Oxford. In her PhD, Bridget explored sexuality and intimacy in advanced cancer and motor neurone disease.

This new session (10_01) provides an overview of intrathecal drug delivery (ITDD) for the management of cancer pain. It aims to enhance the understanding of which patients may benefit from this approach and the principles which govern the safe use of ITDD systems. This session supports all palliative medicine physicians and nursing staff, and those caring for a patient using intrathecal analgesia.

A specific learning path: ELCA Motor Neurone Disease Learning Path has been developed and includes a number of sessions that will support professionals in caring for people living with Motor Neurone Disease (MND). Two sessions have a specific focus on MND:

05_04 Initiating conversations about EoLC: long term neurological conditions

05_06 Case Study Motor Neurone Disease

Other sessions address some key challenges that arise in the care of people with MND and some sessions will help professionals ensure that care is focussed on the holistic needs of patients and their families.

A new framework to personalise services for end of life care patients and their families has been released. Health Education England commissioned Skills for Health and Skills for Care to develop the End of Life Care Core Skills Education and Training Framework, which is set to standardise training for health and social work professionals working with patients needing end of life care.

e-ELCA is referenced throughout the framework as key sessions have been mapped to each subject.

Health Education England e-Learning for Healthcare (HEE e-LfH) is adding the e-LfH Hub and its thousands of e-learning sessions to the list of OpenAthens resources to make it easier for certain groups of the health and social care workforce to access e-LfH’s e-learning.

OpenAthens is a service that allows people to access a series of online resources free of charge with just a single OpenAthens account.

The OpenAthens eligibility criteria, which are managed by NICE, cover anyone working directly with NHS patients. Anyone working directly on the development and/or delivery of training materials for either NHS staff or NHS patients within an organisation that provides NHS-commissioned care or commissions care for NHS patients in England is also covered. This includes charities, voluntary organisations, local authorities, arm’s length bodies and healthcare students.

For more detailed information on the eligibility criteria, and to register, please visit: www.nice.org.uk/about/what-we-do/evidence-services/journals-and-databases/openathens/openathens-eligibility

For more information about accessing e-LfH resources via OpenAthens visit: http://support.e-lfh.org.uk/get-started/openathens/

If you work within a care home or a hospice access to End of Life Care for All (e-ELCA), and other e-LfH programmes, is now really simple. Each care home and hospice has its own registration code and once your manager has requested this, you can use it to register for free access here: http://portal.e-lfh.org.uk/support/

There is also an instruction leaflet available should you need one.

We have recently developed a new session within the e-ELCA programme ‘Symptom Management for the Dying Adult’. This session provides a concise guide to the management of physical symptoms that commonly arise when a person is in the last few days to hours of life. This session is for doctors in training (all specialties), core medical and GP trainees, nurses in the community, hospitals and care homes and post registration pharmacists. It may also be useful to more experienced doctors who wish to refresh their knowledge in this area.

The General Medical Council (GMC) want to help doctors apply their guidance on end of life care in practice and deliver good care to patients reaching the end of their life. As part of a range of suggested learning materials the GMC has recommended the e-ELCA session.  The session explains the key principles in the guidance and helps you to apply them to some of the common challenges that arise when caring for patients towards the end of their life.

For more information visit:
http://www.gmc-uk.org/guidance/ethical_guidance/end_of_life_care.asp

You may have met the e-ELCA team at various events and conferences over the last couple of years. We are attending the National Council for Palliative Care (NCPC) conference in London on 10 March 2017and the Association for Palliative Medicine (APM) Supportive and Palliative Care Conference in Belfast from 29-31 March 2017.

Finally, as part of the continuing review of our programmes all 158 e-ELCA sessions have been fully reviewed and updated.
For more information visit: http://www.e-lfh.org.uk/programmes/end-of-life-care/

e-ELCA and NICE NG31 guidelines

e-ELCA sessions have been highlighted as a resource to help with implementation of the NICE NG31 guidelines. The key sessions signposted are:

• Assessment of dying phase and after death care (02_14)
• “What will it be like?” – talking about the dying process (03_26)
• Discussing ‘do not attempt CPR’ decisions (03_30)
• Symptom management: last days of life (04_23–04_26)
• Discussing food and fluids (03_31)

More information on this can be found here: https://www.nice.org.uk/guidance/ng31/chapter/Implementation-getting-started

Professor Christina Faull 
Former APM  lead for e-ELCA
February 2016

This leaflet is available on the e-ELCA website (http://www.e-lfh.org.uk/programmes/end-of-life-care/). It is intended as a practical guide for managers, as well as trainers, wanting to improve end of life care as it will help motivate and engage learners by highlighting best practice when using e-learning.

All 156 sessions will have been updated by the end of March. Enormous thanks to those of you who have helped me with this. It’s a ‘Forth Road Bridge’ of a task though!

Professor Christina Faull 
Former APM lead for e-ELCA
February 2016

Making the most of e-ELCA

e-ELCA has been recommended as part of a blended learning approach by the ‘Training and Education in End of Life Care’ report, commissioned by HEE to review the efficacy of existing education and training resources on end of life care. Take a look at the new Making the most of e-ELCA guide. It is a simple and concise guide, designed to provide a brief overview of factors that can help organisations maximise the effectiveness and value of using e-ELCA.

Professor Christina Faull
Former APM e-ELCA Lead
November 2015

Are you tired of delivering the same old session on symptom management? Why not try using an e-ELCA session with the group instead? I frequently use session 3.30 Discussing ‘Do Not Attempt CPR’ Decisions for teaching about resuscitation decision making. This brings out great discussions in the group and I don’t have to prepare anything!

The newly updated sessions on assessment and management of constipation may bring a new flow to a dry subject! (metaphors all intended!).

Have you considered how you might use e-ELCA sessions in your teaching? Why not use the recently updated session as a way of getting a group to discuss really important concepts at the heart of advance care planning.

Communicating with Empathy is a six session course that has been developed by PallE8 to promote sensitive and effective communication in end of life care. It is available within the e-ELCA programme and is primarily aimed at non-registered care staff but is potentially suitable for newly qualified professionals and non-clinical staff who interact with patients and families at the end of life e.g. receptionists, ward clerks and volunteers. Multimedia content is integral to the e-learning with extensive video clips drawing on patient, carer and professional expertise as well as simulated scenarios with professional actors.

Suzie Gillon and I recently updated the session Request for Euthanasia (3.20) may be useful to you in your discussions arising in relation to the Assisted Dying Bill.

Please do let me know examples of how you use e-ELCA so I can share with others and also any suggestions for further improvements of these or any sessions.

Professor Dr Christina Faull
Former APM e-ELCA Lead
October 2015

All staff who work in hospices are entitled to access e-elca. When registering they need to use a specific code for their hospice. They can get this from the e-ELCA support team. Alternatively, I’m happy to supply the code to a hospice education lead.

Professor Christina Faull
Former APM e-ELCA Lead
September 2015

The e-learning resources of e-ELCA are universally praised but the biggest criticism is that people don’t know about them. APM members, who have contributed hugely to the development of the 150 sessions, are also key to making e-ELCA used to it’s full potential.

We’re all supporting local initiatives to improve the competence of the health and social care workforce to deliver good end of life care and e-ELCA provides a great resource as part of a blended learning approach. Many of you have said your NHS organisations are looking for this type of information to direct their staff training.

The sessions in e-ELCA have been mapped to the learning objectives of the ‘One Chance to Get it Right’ report and core and additional e-ELCA sessions have been defined for doctors, nurses, AHPs, social care workers, and managers

A newly developed training needs analysis session will help people identify their strengths and weaknesses in end of life care and direct them to pertinent sessions.

Quite a lot of this can be accessed via the website (without the need to register) including a key session (in ’sample sessions’) Recognising the Last Months and Days of Life and Veryfiying Death  Please do share this information with your colleagues and consider using e-ELCA in your teaching.

We want to develop resources to support trainers integrate e-ELCA into their teaching. If you have made use of sessions in courses or within face to face teaching I’d be delighted to hear more.

Professor Christina Faull
Former APM e-ELCA Lead
August 2015

Last autumn I surveyed the SpRs and other members to get to know your thoughts on what sessions for specialists should be prioritised for development in e-ELCA.  A good number of people wanted a session on tracheostomy care.  The good news is we don’t need to develop this as it’s already there!.

If you think we should  do something additional  in this area of care in an e-learning format to support training and CPD then do let me know.

Professor Christina Faull
Former APM e-ELCA Lead
July 2015