Background: Psychological distress is commonly experienced by patients referred for specialist palliative care support. In the UK, hospices provide care, free of charge to patients with advanced disease requiring specialist support to in-patients, out-patients and the community. Availability of psychological support was considered in relation to National Institute of Healthcare and Excellence (NICE) guidance for improving supportive and palliative care for adults with cancer.

Aim: To evaluate how healthcare professionals working in hospices perceived their competence in assessment and screening for referral to specialist psychological services. We also sought to explore the level of training and supervision in psychological approaches undertaken by health professionals working in palliative care.

Methods: An anonymised online survey was emailed to 164 hospices in England to be cascaded to multidisciplinary healthcare professionals. Questions asked individuals about levels of training, self-perceived competence in screening, assessment, therapies and level of clinical supervision received.

Results: One hundred and forty responses were returned from 38 hospices. Access to specialist psychological services was limited in some areas and some staff felt unable to screen and assess patients for referral to these services. Many professionals perceived training and supervision in assessing for and delivering psychological support to be insufficient. Gaps in training were noted for communication skills. Approximately two-thirds of nurses and allied healthcare professionals and 44% of other health professionals did not feel competent at either providing information at an appropriate level, explaining the psychological problem or providing information on treatments available. 

Conclusion/Discussion: Knowledge, training and supervision of health professionals working in hospices vary considerably. There is a need to develop a consistent approach to training in recognition and screening for psychological intervention where specialist services exist. Health professionals undertaking therapy work must do so with adequate training and supervision to enable timely and effective intervention for patients with psychological distress.