#23 Anticipatory Care Planning in Scotland with Dr Tony Duffy

In this episode we explore Advance Care Planning, or Anticipatory Care Planning as it’s called in Scotland, and discuss the challenges of ACP conversations in a Community setting as well as the steps to a successful ACP conversation.

Key messages from guest

• Tony shares how his transition to palliative care began.

• An increasing part of specialist palliative care is sharing knowledge, introducing a palliative approach across all specialities. 

• The provision of EoLC should be the provision of all health care professionals.  

• Scotland follows a unified approach to Anticipatory Care Planning.

• Advance Directive is the Scottish equivalent of English Advanced Decision to Refuse Treatment.

• Continuing Power of Attorney, Welfare Power of Attorney and Combined Power of Attorney are the Power of Attorney processes in Scotland

• Tony describes the process before an ACP conversation begins, highlighting information gathering and the importance of initial introductions. 

• The community environment provides different challenges to communication, a more uncertain environment, which can mean creative ways are needed for effective communication. 

• Why first impressions are so important.

• Tony shares the skills he uses in assessing the environment and the cues this can give for care needed.

• Listening to a person describe their illness can give great indications to where that person is with their illness.

• Preparation before meeting, introductions to palliative care, gentle story goals, exploring last week/months, photos and asking a person to explain where they are in their illness journey  and  an example of Advance Care Planning without label.

• Advance Care Planning is a dynamic process which needs frequent reviews.

Resource

• Read Tony’s Palliative Reflections blog 

• NHS INFORM Anticipatory Care Planning 

• NHSS Scotland Anticipatory Care PLan document 

• Find out more about SPICT 

• Advance Directives: Scotland 

• Making a Lasting Power of Attorney in Scotland 

• BMJ paper mentioned by Tony Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners 

Dr Tony Duffy MSc, MBChB (Hons) MRCP Specialty is a Community based Dr in Palliative Medicine St Columba’s Hospice.

Background: Car mechanic and Publican in a prior life medicine. Acute medicine trainee with a move to palliative care in 2016. 

Clinical interests: Antibiotic use towards end of life, safer prescribing, philosophy and history of palliative medicine. Education and social media in palliative care

Personal interests: Japanese car enthusiast, guinea pigs, soft pastel artist, blues guitarist, heavy metal enthusiast, running.

Connect with Tony on Twitter @Existential_Doc

Find out more about my Bespoke Consultancy

• Service analysis for teams seeking to improve EoLC or prepare for CQC

• End of Life Care Education

• Lasting Power of Attorney Consultancy

• Talks and presentations

If you’d like to find out more about my work contact me.

What one thing will you do?

It would be great to share what resonated with you from this episode, what is the one thing you will do differently? Head to Twitter, Facebook or LinkedIn to continue these important conversations.

Thanks to all my guests for working with me to share their knowledge, experience and stories about Advance Care Planning. I hope you enjoyed listening and have insights to take away; I love hearing your reflections on the series and look forward to reviews on Spotify where you can also subscribe to the series.

Clare

Important Conversations about Important Conversations.