Having Good Conversations

We need to have good conversations where we can talk openly and honestly about people’s wishes and their health goals. We also need to make sure they have all the information they need to make informed choices and understand the benefits and limitations of different treatments.

Getting Started

Good communication is the key to success. Some people will not have considered these topics before. It is important that you give them time and space to reflect before having these conversations.

It may be useful to have an introductory conversation with people and those that matter to them, explaining that you would like to have further conversations soon. You can signpost them to the information in these pages.

Raising Important Topics

These discussions are really important; however we understand that some staff members might not always feel comfortable having them. Try not to overcomplicate the matter – we can often start conversations with a simple question like ‘what matters to you?’ or ‘how would you feel if you have to go to hospital?’ and we often find that people are keen to discuss this, as are those who matter to them.

What should we DISCUSS?

We have created some resources to help you think about the different topics you could talk about as part of an Future Care Planning Conversation. They use the “DISCUSS” framework.

You may also feel like you don’t know enough about some topics to give advice to others. For example you might not feel able to answer some questions about DNRCPR, or you might be unsure of the level of support home care can give. If someone asks a question that you don’t know the answer to, be honest about this. Tell them you aren’t sure right now but you will find the information and get back to them. Talk to your colleagues to try and find out the necessary information or you can email ACPSupport@ggc.scot.nhs.uk.

Encourage Questions – It’s Okay To Ask Campaign/BRAN Questions

During these conversations, it is important that everyone is given a chance to express their views so that we can make shared decisions. It is also important for professionals to check in with people to make sure that they understand what is being discussed and are happy with the plan.

The BRAN Questions can be a useful way to check that everyone has the information they need to make an informed choice about different treatments or plans. These are four questions that ask about the benefits, risks and alternatives of treatment, as well as what would happen if we did nothing.

B – What are the Benefits of this test or procedure?
R – What are the Risks of this test or procedure?
A – Are there any Alternatives?
N – What if I do Nothing?

BRAN also applies to clinicians! We should also ask ourselves:

B – Will this patient really Benefit from this test / procedure / hospitalisation?
R – Am I exposing this patient to Risks?
A – What Alternative options have we discussed?
N – if I were this patient, would I consider doing Nothing at this stage?

Visit the NHS Inform: It’s Ok to Ask website for more information.

Training and Skills Practice

Communication is a skill which needs practice. There are lots of different courses and resources available to help you think about how to communicate with other. Here are some of our recommendations:

Face to Face Training Courses*

Sage & Thyme Communication Training

The MAP of Behaviour Change

*Please note that some of these course may not currently be running or may have moved to a virtual platform.

Online Modules

We have created our own online e-learning module which gives you a general overview of Future Care Planning.

There are 2 Learnpro Modules we would suggest. Please note you will need to have a Learnpro account to access these.

GGC 028: Anticipatory Care Planning

GGC 053: Palliative End of Life Care

The NHSGGC Primary Care Palliative Care Team run a variety of online and face to face training, including sessions on Future Care Planning, communication skills and DNACPR.