nmrcgp for consultants

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Palliative Care/Oncology

This is what our GP trainees need to achieve during their time at your department. We've classified them under the six main compentency domains for general practice..

1. PRIMARY CARE MANAGEMENT

• Knowledge of the epidemiology of major cancers along with, risk factors and unhealthy behaviours
• Knowledge of the principles and design of primary and secondary screening programmes
• The ability to function as both leader and member of cancer care teams, as required
• Knowledge of referral guidelines and protocols, both local and national
• Knowledge of the principles of palliative care and how it applies to non-cancer illnesses such as cardiovascular, neurological, respiratory and infectious diseases.

2. PERSON CENTRED CARE

• The ability to attend to the full range of physical, social and spiritual needs of the patient and carer
• The ability to communicate effectively with the patient and carer regarding difficult information about the disease, its treatment or its prognosis
• Knowledge about how to provide and manage 24 hour continuity of care through various clinical systems

3. PROBLEM SOLVING SKILLS

Specific problem-solving skills
• Knowledge of the signs and symptoms of the early presentation of cancer
• The ability to suspect a cancer diagnosis early in the disease process
• Knowledge of the appropriate investigations of patients with cancer and of how they fit in with national guidelines
• The ability to manage pain

• Knowledge about a syringe driver:
 Suitable drugs
 Conversion of drugs from oral dosage to syringe drive, either, IV or subcutaneous

• The knowledge of various palliative care emergencies and their appropriate management:
• Major haemorrhage
• Hypercalcaemia
• Superior Vena Caval obstruction
• Spinal cord compression
• Bone fractures
• Anxiety/panic
• Use of emergency drugs

Moved from psychomotor skills
In reference to a syringe driver:
• Give Suitable drugs
• Convert drugs from oral dosage to syringe drive, either, IV or subcutaneous

4. COMPREHENSIVE APPROACH

• The ability to manage cancer and non-cancer symptomatology in the same patient
• The ability to counsel and explain:
• Risk of disease
• Behaviour change
• Treatment options
• symptom control

5. COMMUNITY ORIENTATION

• Knowledge of the social benefits and services available to patients and carers
• Understand the current population trends in the prevalence of risk factors and cancer in the community.
• Appreciate the importance of the social and psychological impact of cancer on the patient’s family, friends, dependents and employers.

6. HOLISTIC APPROACH

• The ability to offer spiritual care the patient and carers
• Knowledge of normal and abnormal grieving and its impact upon symptomatology

All these 6 domains have a

7. Contextual Aspect

• Understand the key government policy documents that influence healthcare provision for cancer and palliative care.
• Recognise how geographical factors influence the prevalence and treatment of cancers.

8. Attitudinal Aspect

• Knowledge of the ethical dimensions of treatment and investigation choices, palliative and terminal care, and advanced directives
• Knowledge of the ethical principles and how they apply to cancer care and control
• Knowledge of their own personal attitudes and experiences which can affect their attitude towards patients with cancer or who are dying

9. Scientific Aspect

• The ability to define and apply evidence-based care in patients with cancer
• The ability to learn from the clinical experience
• Knowledge of cancer treatment trials and how to inform patients about their participation