Advance Care Planning

The publication of a new Advance Care Planning (ACP) policy in October 2022 has provided an updated and welcome regional direction for the population in Northern Ireland (NI). https://www.health-ni.gov.uk/publications/advance-care-planning-now-and-future

ACP has been described as a mechanism for individuals to establish decisions about future care that take effect when they lose the capacity to make informed decisions (National Institute for Health and Care Excellence (NICE), 2018). The new guidance in NI advocates that ACP should be an important part of life for all adults, this public awareness approach to ACP has evolved a concept that was usually associated with end-of-life care.

For our nursing members here in NI, who are providing care or treatment, the new ACP policy aims to guide and inform them, with an ambitious statement of ‘When a person’s wishes, feelings, beliefs and values are known, it can help to promote their autonomy and rights, and reduce any potential distress for the person and for those important to them.’ 

With the introduction of the ACP policy, it was recognised that there are ongoing needs for education and training for nurses for effective engagement, and areas such as the professional and legal components of ACP require a greater understanding by nurses. With this in mind, the professional practice team in NI developed a level 2 ACP training program. There is a short level 1 virtual ‘awareness’ program for all health and social care staff, through HSCLearn. https://www.hsclearning.com/course/view.php?id=1189

The first level 2 sessions will be delivered as a pilot, funded by the Public Health Agency, in March 2023, sessions are already fully booked with a significant presence from nurses who work in the independent sector.

The objectives of the program are to increase the knowledge, attitudes and confidence of nurses which will help to support engagement in ACP. Whilst a knowledge of the ACP framework and process of reporting and recording decisions are part of the training, the main component will be communication skills. As nurses we often have difficult conversations with our patients, especially when discussing wishes and preferences for their future care.

We plan to undertake a pre and post evaluation of the 2 ACP pilot sessions, to establish the impact of the program. We would then going forward place the program in the NI professional practice prospectus.