Improving Palliative Care: The Conversation Project

This project introduced by the Palliative Care Team at the Royal United Hospitals Bath NHS Foundation Trust aims to support the education, development and support for staff to increase the quality of end of life care for patients, families and staff across the Trust |  NHS England | The Atlas of Shared Learning


Nursing leadership in the Palliative Care Team at the Royal United Hospitals Bath NHS Foundation Trust identified that staff had more confidence in supporting patients with palliative and end of life care in the last few days of life compared to the weeks and months prior to a patient dying. This unwarranted variation led to the Palliative Clinical Nurse Specialists initiating a response with ‘The Conversation Project’.

The Conversation Project was developed to support and provide the focus for change that had been identified as needed.

The things that needed to change included:

  • An earlier recognition that the patient is approaching the end of their life or is facing an uncertain future;
  • To facilitate and raise awareness for the need for earlier conversations with patients and families about their current situations;
  • To improve the documentation of those important conversations;
  • To include these discussions in the ward multidisciplinary team (MDT) meetings to support a shared involvement and understanding of the needs of the patient and family;
  • To improve the transfer of information pertaining to a patient’s end of life on discharge or transfer of care;
  • To bring about a cultural shift in how their hospital recognised and engaged in the care of the dying;
  • To ‘normalise’ end of life conversations and to help staff recognise that anyone of us could be with patients when they wish to discuss their fears and wishes as their condition deteriorates.

Full detail about the project at NHS England

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