End of Life Care for All e-learning (e-ELCA)

Waiting for a meeting?  Travelling on a train?  A spare 20 minutes before lunch? Why not open an End of Life Care for All (e-ELCA) e-learning session and learn something new?  Created in 2010 and completely updated in 2015, e-ELCA is an e-learning programme aimed at enhancing the training and education of all those involved in providing end-of-life care. It is managed by Health Education England’s e-Learning for Healthcare programme in partnership with the Association for Palliative Medicine of Great Britain and Ireland (APM).

e-ELCA has over 160 e-learning sessions written by specialists in the field of palliative care in the UK and Ireland. The sessions are grouped into subject specific modules about advance care planning, symptom management, assessment, communication skills and bereavement, two modules that focus on learning for social care, spiritual care and a module that uses case scenarios to help integrate learning.  More information about the background and detail of the content can be found in our recent EJPC article – please see below.

You can register for e-ELCA or if you are not eligible you can purchase it. Thirteen sessions are free to access.  Additionally Recognising the Last Months and Days of Life is available as a sample session.   This is a very important session to help doctors and nurses address the significant issues that recent reports about the quality of end of life care have highlighted.

You can see further how e-ELCA sessions can support the competences required to meet the Priorities of Care of the Dying Person report by you or your trainees, students or colleagues completing a Training Needs Analysis.   NICE has indicated that e-ELCA sessions are a good way of supporting implementation of the Guideline for Care of Dying Adults in the Last Days of Life.

Many specialists in palliative care are using the sessions within their teaching. For example for a course about advance care planning (ACP) Introduction to Principles of Advance Care Planning may be used to bring course participants to a common level before attending a study day. This ACP course may also make use of e-ELCA material for discussion within a group (for example How to Negotiate Decisions Which May be Difficult to Implement) and perhaps as a way to consolidate or further learning (for example  Developing Your Practice: Clinical Supervision and Further Reading.  There are tips about how e-ELCA can motivate and engage learners and suggested learning paths or collections of sessions to support staff groups.  In addition e-ELCA sessions have been mapped to the end of life care qualification, especially useful for social care workers.  Mapping to the Association for Palliative Medicine of Great Britain and Ireland Undergraduate Medical Student Curriculum is underway.  Keep in touch through the e-ELCA website

My personal favourite session is Spirituality and Philosophy of End of Life Care.  It’s a session that makes me think and reflect even after over 25 years of supporting people who are dying. The importance of the holistic approach to people in finding themselves, is so beautifully articulated through a patient video.  A good way to spend those 20 minutes!

European Journal for Palliative Care July 2016

Professor Christina Faull
Consultant in Palliative Medicine
LOROS hospice, Leicester UK
APM National Clinical Lead for e-ELCA
@cmfaull

Perinatal Mental Health

July 2016  

Dr Carrie Ladd – @LaddCar

Royal College of General Practitioners Clinical Fellow in Perinatal Mental Health and GP in Oxfordshire

Although society has instilled a deep expectation that women will make a seamless transition to motherhood, there is much potential for ill health – both physical and psychological. Women may experience mental health problems similar to other times of life such as depression or anorexia but also conditions specific to the perinatal period such as postpartum psychosis. 1 in 5 women suffer mental health problems during this time but unfortunately only 50% of cases are diagnosed and even less receive the recommended specialist perinatal mental health care, meaning many women slip through the net.

There are many reasons for this under detection including the under reporting from women of symptoms for fear of failure, judgement, stigma or the involvement of social services leading to the separation from their baby. During a woman’s perinatal journey, health professionals have numerous opportunities to ask about mental health symptoms and to pick up a problem when there is one. Competing priorities, time pressures and a presumption someone else has asked are all reasons why health professionals may not ask a woman about their mental health and so miss a crucial diagnosis.

The consequences of untreated maternal mental health problems are immense. As well as the emotional, physical and psychological effects on the woman, her child may be affected too both in the short and long term. It is estimated the economic burden of maternal mental health problems is £8.1 billion for every one-year cohort of births and approximately 75% of this is for impact on the child in education and social care amongst other areas. However, in the absence of other adverse factors, early recognition and prompt treatment can mitigate this risk leading to better outcomes for all involved.

So how can those of us who work with women during the perinatal time improve this situation?

An excellent place to start is the five module e-learning series on perinatal mental health available on the Health Education England e-Learning for Healthcare (HEE e-LfH) platform, produced in conjunction with the Royal College of General Practitioners (RCGP) and available via open access to all. These are aimed at all healthcare professionals who may be involved in the care of women during the perinatal time. They have been written by five different authors including a consultant psychiatrist, obstetrician, health visitor, midwife and myself each giving a different perspective.

http://www.e-lfh.org.uk/programmes/perinatal-mental-health

As well, the RCGP in conjunction with NHS England has produced a toolkit of resources for health professionals to help women with perinatal mental health problems. This is a diverse collection of clinical guidance, waiting room posters, teaching material, third sector organisations, video links, website links and lots of useful patient information leaflets. It is not intended as a comprehensive text book but it is hoped to complement and support the current provision of advice, treatment and support for women & their families experiencing mental health problems during this time. The toolkit is available now with open access on the RCGP website.

 

References:

1: Bauer A, Parsonage M, Knapp M et al. The costs of perinatal mental health problems. 2014; London: Centre for Mental Health

  1. Khan L. Falling through the gaps: perinatal mental health and general practice. 2015; London: Royal College of General Practitioners and Centre for Mental Health.