Let's talk: Transforming end of life conversations

Opening up the conversation about death, dying and grief

Guy’s and St Thomas’ NHS Foundation Trust is committed to improving the experience of patients, carers, staff and the general public in talking about and preparing for death, both in hospital and in the wider community.

Supporting patient conversations

Our patients and their carers tell us that conversations about end of life care can come as a shock and that it can be challenging to remember the detail of what was discussed. We’ve worked with patients, carers and healthcare professionals to develop a leaflet and four short videos that explain how decisions are made, options for place of care, how to plan when recovery is uncertain and do-not-attempt-cardio-pulmonary-resuscitation orders. These resources are offered to patients and carers to support understanding of conversations had with our healthcare professionals.

Transforming end of life care lead Kimberley St John leading a conversation with comedian Cariad Lloyd, journalist Erica Buist and Kris Hallenga from Coppa Feel during the 2019 VAULT festivalPublic information

We are working with our community of Lambeth and Southwark to open up the conversation about death, dying and grief. We hope that by talking making these conversations normal, we’re preparing our future patients and their families and building capacity to support each other. We have worked with a range of organisations including VAULT festival (pictured right), More Yoga, Healthwatch, Picturehouse Cinemas and Bubble Theatre. We will continue to plan a diverse range of events throughout 2019.

Education and training

We are improving our education and training. We have developed an e-learning module for our staff that focuses on communication skills and process around treatment escalation planning. Our module uses an actor and clinician in role play, providing healthcare professionals the opportunity to observe the conversation and the correct process.

The 'Second Conversation' is an on-the-job training tool designed to improve junior doctors confidence in end of life care conversations. This was developed by the Royal College of Physicians and Guy’s and St Thomas’ Hospital. We launched this across our Foundation programme in 2018, with over 90% of our trainees using this tool to practice their skills.