Update on Siân Evans legacy fund

Introduction
This paper provides a brief update on the progress of funding provided by Dr Tyrrell Evans and Isabel Potter in memory of Siân Evans, to support GP education and training in palliative and end of life care.

Date
17th December 2024

Final summary of the GP Community of Practice

Background and original objectives
The GP Community of Practice was developed in response to the understanding that “hospices and hospitals cannot look after all of us when we die, and so enabling more GPs to help look after and care for the dying feels the right thing to do.” Tyrrell Evans

The community has been developed to advance the understanding of those GPs new to the profession in relation palliative care and the multi-disciplinary services available to patients approaching the end of life.

Key outcomes to be delivered
1. To develop palliative care knowledge for GP trainees in their final year (ST3) and GPs in the first five years after completion of training
2. To provide a collaborative community where peer learning is encouraged in a safe space
3. To develop greater resilience and a shared sense of pastoral support for delegates
4. To provide the delegates with clinical expertise and professional development opportunities
5. To create greater confidence in prescribing for palliative care patients
6. To provide support in relation to ethical dilemmas that may arise looking after this patient group

Programme of work
1. GP Study day Nov 2023 as a place to launch the GP Community of Practice and to gain insights into the topics and themes to be discussed in the community
2. Create a resource page for the community to engage with relevant wider reading and useful reference points for additional learning
3. Launch of the GP community of practice & associated Discord group
4. Carry out 11 monthly sessions, each with a topic and discussion points
5. Continued marketing and engagement of new delegates into the community
6. Mid-point review of the community in April following the 5th session
7. Carry out increased marketing actions for the remainder of the programme
8. Final GP CoP session in November 2024
9. Full review of GP CoP and Professional Learning approach to GP education in January 2025.

Progress towards outcomes for project
Between Dec 2023-Nov 2024 St Christopher’s CARE hosted 11 virtual community of practice sessions totaling 19 hours of learning for 24 GPs.

Attendees heard from 8 different experienced palliative and end of life care clinicians throughout the year. The sessions focused on areas of interest that were suggested by the community and provided opportunity to discuss case studies, discuss challenging situations and have time for questions with experienced GPs and peers for collaborative learning.

The attendees were given access to Discord platform for networking, forum discussions and sharing of resources and recordings.

Work location of attendees
The majority (50%) of delegates are from Lambeth borough of London. 29% of attendees were from outside of London SE boroughs, including from Rugby, Swindon, Nottingham, Dorchester and Tetbury. (see image below)

Topics

Topics were suggested by the community with popular choices being dementia and agitation, challenging relatives and anticipatory medicines.

- December 2023: Pain
- January 2023: MND
- February 2023: Advance Care Planning
- March 2024: Anticipatory Prescribing
- April 2024: Deprescribing
- May 2024: Heart Failure
- June 2024: Fundraising
- July 2024: Learning Disabilities
- September 2024: Nausea and Vomiting
- October 2024: Social Work
- November 2024: Reflections

Marketing

Recommendations and mailing list emails proved to be the most effective method of gaining new attendees. (see image below)

Experience of learners

The community of practice has 24 members with 100% of sessions being evaluated as 4 or 5 stars. 100% of learners agree that the community supports them in their practice.
91% of learners would recommend the community and 42% of delegates have joined via recommendation.
Testimonials:
“Really useful session on heart failure with interesting case studies.”
“Extremely helpful session, concise and not overwhelming knowledge with a rare chance to ask questions to very experienced professionals, thank you again”
“I find it a really great environment for learning, it’s really easy to ask questions and discuss things where there isn’t a clear-cut answer”
“I think it’s a really valuable resource to help GPs provide good palliative care in the community”

Learner recommendations
Recommendations for future learning opportunities focussed on ease of access to overcome challenges with time restraints and limited CPD time allowances:

- Pre-recorded bite-sized learning resources
- Evening sessions
- Sessions 30mins max
- Monthly drop-in sessions
- Online community-based discussions
- Collaborate with existing training schemes to reach GPs where they are already learning

Professional Learning recommendations
St Christopher’s CARE to carry out a full review of the community of practice and our approach to GP education going forward.