What makes a paediatric palliative medicine (PPM) paediatrician?
A paediatric palliative medicine (PPM) doctor has expertise working with neonates, infants, children and young people with life-limiting conditions and life-threatening illness, and their families. These conditions include malignancy; inherited disorders; cardiac, neurological and neuromuscular diseases; and a variety of rare progressive and irreversible conditions.
PPM doctors work alongside multidisciplinary teams (MDTs) across hospital, hospice and community settings, providing a total approach to care and focusing on quality of life. The approach embraces physical, emotional, social and spiritual elements. These consultants provide:
- specialist symptom management (eg nausea, pain, breathlessness, and agitation)
- guidance on advance care planning (eg the preferred place of care, and ceilings of care)
- guidance on end-of-life and bereavement care
- support with complex ethical decisions (eg feeding and hydration).
The PPM doctor also plays a vital role in supporting other healthcare professionals to care for children with life-limiting conditions.
RCPCH Progress curriculum
As of 1 August 2018, sub-specialty trainees use the RCPCH Progress Level 3 Generic syllabus alongside the RCPCH Progress Paediatric Palliative Medicine Syllabus which is available to download below.
Exceptions to this are those trainees who will CCT (certificate of completion of training) before 15 September 2019 - the 2010 curriculum is available to download below.
Sub-specialty learning outcomes
In addition to the generic learning outcomes for level three, paediatric palliative medicine trainees must fulfil the requirements below:
- Demonstrates specialist expertise in the management of life-threatening illness and life-limiting conditions across the paediatric spectrum, from the unborn baby, neonate and infant, to the child and young person.
- Works as a specialist expert in paediatric palliative medicine across a range of settings and within the MDT, by providing a holistic approach to care.
- Recognises, assesses, anticipates and manages the full range of symptoms experienced as disease and illness progress.
- Prescribes, reviews and monitors pharmacological treatment and non-pharmacological interventions necessary to manage patients with life-limiting illness, and at the end of life; ensures non-pharmacological interventions are integrated into care at all stages of management.
- Works together with patients, families and professionals to facilitate decision-making regarding planning and provision of care towards the end of life; ensures good practice and provides appropriate support and guidance in decision-making and advance care planning.
- Makes complex decisions and supports others making complex ethical decisions within the recognised UK framework.
- Demonstrates expertise on the physiological process and practical requirements of death and dying in childhood.
- Recognises grief and the need for bereavement care, including support for all family members and those who require specialist input.
- Recognises the impact of managing stressful, sensitive and often complex situations; the impact of multiple bereavements and the risk of burnout specific to palliative medicine; and the vulnerabilities of practitioners and colleagues.
- Works as a leader to improve evidence for, access to, and provision of paediatric palliative care.
- Possesses the procedural skills necessary to practise competently and effectively as a palliative care consultant, with the confidence to advise and support others.
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