District and community nurses who completed a practice-based educational pathway reported greater confidence in delivering palliative and end of life care to patients.

Nurses working in these roles said communication was their main area of concern in relation to end of life care but this increased significantly during the project, due to interaction with colleagues experienced in this area.

The pathway involved assigning community nurses from one NHS foundation trust in the north of England a mentor from a specialist palliative care team.

It focused on four main areas of care: advanced care planning, communication skills, assessment and care planning, and symptom management, maintaining comfort and wellbeing.

The nurses undertook a training needs analysis and created their own development plan, including a range of formal and informal education.

As a result, participants reported a rise in confidence, particularly in communication skills and symptom management.

The study findings, published in Primary Health Care, revealed that developing mentoring and support networks between community services and end of life care specialists is a potentially powerful approach to educating community nurses.

The authors recommend a larger, long-term study to investigate duration of increased confidence and the extent of knowledge and skills gained.

They urge nurses and their managers to lobby their local organisations for support in setting up similar training initiatives.