Implementation of an Innovative Palliative and End of Life Care Education into Nursing Homes

Theresa Richards

Betsi Cadwaladr University Health Board

Project Scope

The six steps palliative and end of life care education programme was implemented by the Macmillan End of Life Care Plan Facilitation team in 2013 to provide end of life care training across North Wales to Nursing homes that will result in high quality care and improved outcomes and experiences for their patients and families. It is vital that residents have access to timely, skilled care and support as this can avoid unnecessary emergency admissions to hospital, and can enable more people to live and die in the place of their choice. Up to date 75 care settings and 122 champions have gone through the programme. Work continues with Flintshire county Council who we have been successfully working with throughout the programme. Key Stakeholders include Betsi Cadwaladr University Health Board (BCUHB) and Macmillan cancer support.

Starting Conditions

We focused on 12 Nursing Homes in North Wales (west) that took part in the six steps programme which took place between November 2015 and July 2016. This was delivered by the Macmillan End of Life Care Plan Facilitation Team at BCUHB.

There were 20 registered nurses who attended the programme of workshops; seven half day and one full day session.

Venues were organised close to the areas where care homes were situated.

Lewin’s forcefield was used to identify the drivers and resistors to change. Attended meetings with influential drivers within the organisation. Spoke to resistors within care home sector who did not understand the impact or potential of the programme. It was important to find out the values of the organisation in relation to palliative and end of life care, we used the McKinseys 7s model.

Shared Values

The All-Wales End of Life Care Delivery Plan (WG 2016). Residents in care home settings in North Wales have quality palliative and end of life care. The organisation supports care home staff to improve their knowledge and skills in palliative and end of life care to aid reductions in unscheduled admissions into secondary care.

Goals & Targets

That all nursing and residential homes in North Wales have had opportunity to attend the six steps to success programme.

That BCUHB promote the programme in all care settings.

Key targets include:

Interventions and Plans


All goals and targets have been achieved for this project.

Fit with Prudent Healthcare

Part of Cohort Bevan Exemplars 2015-16