21 Identifying gaps in skill level and confidence of healthcare professionals working in palliative care settings in leading advance care planning discussions with patients

<h3>Background</h3> Advance care planning (ACP) supports patients in considering preferences for care in anticipation of deteriorating health. More patients require palliative care, yet ACP is lacking. This research evaluates skill and confidence levels of healthcare professionals working in palliative care settings, in leading ACP discussions with patients. <h3>Methods</h3> An online survey was sent to healthcare professionals within the West Midlands palliative care network. Quantitative analysis reviewed perceived effectiveness and content of, and barriers to, ACP. The impact of recent training and discussion frequency on confidence was determined. Analysis considered the influence of setting on participants’ difficulty to establish the right time for ACP. <h3>Results</h3> All participants (n=39) report ACP is valuable for palliative patients, with 85% having daily or weekly discussions. Participants were confident in leading discussions, with 90% confident to initiate and 95% to review ACP. Only 64% consider ACP effective in the local setting. A significant difference was identified between settings in participants’ difficulty in establishing the right time to engage patients in ACP, using a Kruskal-Wallis test (p=.049). In the last year, 38% had not received ACP training. However, 97% of respondents agree there is a need for further resources and 92% further training. <h3>Conclusion</h3> This research will inform training and resources to address barriers and support the confidence and skill of healthcare professionals in their invaluable efforts of leading ACP discussions with patients. This aims to improve clinical practice within the local setting and increase the number of patients who wish to be supported with ACP.