Royal United Hospitals Bath

Palliative Care

Films

Conversation Project Films

Introduction

These films are for healthcare professionals to support learning and reflection.

These films have been developed to support the conversations healthcare professionals may have with patients, families and carers when facing an uncertain future or approaching the end of their lives.

Patients, families and carers often appreciate opportunities for honest, open conversations and to be listened to about what matters to them most. The need for compassionate conversations can arise when people are feeling worried, vulnerable or facing decisions about their future treatment and care.

It is important that we give patients the opportunity to talk about what is important and what matters most to them, when recognising that they are living with uncertainty or nearing end of life. Some patients may limit the information they wish to receive, others may need support to think about and focus on what is most important to them.

Some healthcare professionals may shy away from these conversations, for fear of not having the right skills or answers to questions. Some may worry about causing distress or where the conversation might lead to. Pressures of time and work can also prevent conversations from being started. However, conversations of great importance to patients and families can take place in relatively short periods of time, with different members of the MDT, and the films help show this.

Healthcare Professionals reflections

These films include 8 healthcare professionals sharing their reflections on having advance care planning and 'what matters' to you conversations with patients and families. The film has been developed to support staff learning and personal reflections on having these important conversations.

	Having Conversations – insights from healthcare professionals 8 healthcare professionals share insights from having advance care planning and 'what matters to you' conversations. Themes from the CHAT Bundle are used through this film. Film length 32 minutes
	Having Conversations – insights from a palliative care consultant Dr Ed Presswood shares how he supports 'what matters to you' conversations. Film length 21 minutes
	Having Conversations – insights from a consultant geriatrician Dr Helen Milbourn shares how she supports 'what matters to you' conversations. Film length 13 minutes
	Having Conversations – insights from an OT Beth Lovering shares how she supports 'what matters to you' conversations. Film length 19 minutes
	Having Conversations – insights from a hospital chaplain Philip Turners shares how he supports conversations around what is important to you. Film length 14 minutes

If you watch a film or series of films, please complete this short evaluation - thank you.

Scenarios - Conversations with patients and families

These films have been made by the Palliative Care Team at the Royal United Hospitals Bath NHS Foundation Trust (RUH), to support communication skills used in 'normal' end of life and planning ahead conversations.

The scripted dialogues in the films are not perfect examples of conversations, but have been developed to prompt thought and create discussion about what we might consider to be useful and important. These films depict both hospital and community settings and include skills, phrases and manner that are applicable in any care setting.

The parts are played by volunteer actors and healthcare professionals and the Palliative care team are grateful to everyone involved that enabled these films to be made. This includes The Health Foundation and Bath and North East Somerset CCG for their funding support. We hope you find them helpful and use them as part of individual learning or group discussion.

If you watch a film or series of films, please complete this short evaluation – thank you.

Conversation Project Films - Evaluation

The Conversation Project ACP films

Each film has an introduction and reflective questions at the end to support learning. The films can be paused if required to support group work with the reflective questions.

The films are not in sequence and can each be viewed as stand-alone scenarios.

	Supporting a relative (nurse and carer) A conversation between a nurse and a patient's husband, to check his understanding of how unwell his wife is, to help him make important decisions to support patient and family-centred care. Film length 7:32 minutes
	Planning ahead (occupational therapist and patient) A conversation between an Occupational Therapist (OT) and a patient about how she is managing. The OT then takes the opportunity to open the conversation to start to introduce the idea of 'planning ahead.' Film length 9:35 minutes
	Listening to distress (healthcare assistant and patient) A healthcare assistant (HCA) recognises the cue that the patient has concerns and worries. She uses this opportunity to listen to his concerns and asks what matters most. Film length 6:40 minutes
	Wishes and preferences (nurse, patient and her daughter) A nurse checks with the patient and her daughter their understanding of the plan for discharge home to support care at the end of life, and that this is still their wish. Film length 6:14 minutes
	A family adjusting (nurse, occupational therapist, patient and her daughters) A conversation between healthcare professionals, patient and family, to establish their understanding what has happened, listen to their concerns and help them to plan for future care. Film length 9.59 minutes
	Advance Care Planning (GP, patient, her sister and son) A doctor recognises the need to have a conversation with a patient and her family about what is important to them now, thinking ahead and having a Treatment escalation Plan. Film length 10.5mins
	Family expectations (GP, 2 daughters and care home manager) A conversation with 2 daughters about the care and support for their elderly father, who is in a care home. The GP explores their understanding of how frail their father is and options for ongoing care and support. Film length 11.5mins
	Recognising how to support discussions with children (nurse and a family) A conversation between a nurse, a son and daughter of an elderly patient who is nearing end of life. The nurse explores how the son and daughter could have conversations with their own children about their grandad. Film length 8.5mins
	Recognising Spiritual Needs (nurse and patient) A conversation between a nurse and a patient exploring spiritual need and trying to understand what matters to this patient. Film length 8.5mins