Adams M, Robert G, Maben J ‘Catching up’: the significance of occupational communities for the delivery of high quality home care by community nurses. Health (London).. 2013; 17:(4)422-438

Brunetto Y, Shriberg A, Farr-Wharton R, Shacklock K, Newman S, Dienger J The importance of supervisor-nurse relationships, teamwork, wellbeing, affective commitment and retention of North American nurses. J Nurs Manag.. 2013; 21:(6)827-837

Casement P On learning from the patient.London: Routledge; 1985

Conley R The 5 causes of psychological safety and why you need to be a safe leader. 2018;

Copeland A NHS sickness absence: let's talk about mental health. Blog. The King's Fund.. 2019;

Coxon G Mental health competencies for practice and community nurses. Nursing in Practice.. 2012;

Doka KJ Caring for the carer: the lessons of research. Prog Palliat Care.. 2014; 22:(3)150-154

Duarte J, Pinto-Gouveia J The role of psychological factors in oncology nurses’ burnout and compassion fatigue symptoms. Eur J Oncol Nurs.. 2017; 28:114-121

Resilience: a framework supporting hospice staff to flourish in stressful times. 2015.

Hunter J End of life care in England: a briefing paper. Institute of Public Policy Research. 2018;

Hussain FA, Kingsley M, Phil-Eboise J Psychological gaps in cancer care: implications for service users and providers. British Journal of Healthcare Management.. 2016; 22:(12)607-615

Achieving world-class cancer outcomes. A strategy for England 2015-2020.. 2015;

Kamau C, Medisauskaite A, Lopes B Orientations can avert psychosocial risks to palliative staff. Psychooncology.. 2014; 23:(6)716-718

Kingsley MJ, Crowe DA, Royan L Havering oncology community team/palliative care and clinical health psychology services business case.London: North East London NHS Foundation Trust;; 2015

National Council for Palliative Care (NCPC) briefing. 2015.

Improving supportive and palliative care for adults with cancer. 2004.

Our national workforce skills development unit welcomes the Interim NHS People Plan. 2019.

Atlas of variation for palliative and end of life care in England. 2018;

Rafferty MA A conceptual model for clinical supervision in nursing and health visiting based upon Winnicott's (1960) theory of the parent-infant relationship. J Psychiatr Ment Health Nurs.. 2000; 7:(2)153-161

Redshaw S, Harrison K, Johnson A, Chang E Community nurses’ perceptions of providing bereavement care. Int J Nurs Pract.. 2013; 19:(3)344-350

Rokach A Caring for those who care for the dying: coping with the demands on palliative care workers. Palliat Support Care.. 2005; 3:(4)325-332

Rothwell C, Kehoe A, Farrook S, Illing J The characteristics of effective clinical and peer supervision in the workplace: a rapid evidence review. Final report. 2019;

Shipman C, Levenson R, Gillam S The King's Fund. Psychosocial support for dying people.. 2012;

Advantages and disadvantages of surveys. 2012.

The psychological impact of cancer: commissioning recommendations, pathway and service specification on psychosocial support for adults affected by cancer. 2018.

Wakefield A Nurses’ responses to death and dying: a need for relentless self-care. Int J Palliat Nurs.. 2000; 6:(5)245-251

The NHS crisis of caring for staff: what do we need to do? Blog. 2019.

Level 2 clinical supervision for community practitioners working with palliative and end-of-life care patients

26 January 2023
Volume 32 · Issue 2


Background: Little has been written on the availability of specialist level 2 supervision groups to support community practitioners regarding the emotional components of their palliative and end-of-life caseload. Adapted level 2 groups (AL2Gs) have been piloted in three community teams in the NHS to address this. Aims: This study aimed to evaluate whether access to AL2Gs benefited community palliative and end-of-life practitioners at three sites. The outcomes for those who attended and those unable to attend were considered. Findings: Attendees found AL2Gs beneficial, reporting better confidence and wellbeing, plus a sense of containment through group cohesion and trust in the facilitators and fellow AL2G members. Most would recommend the groups to all staff working in community palliative care. Practitioners who were not able to attend relied on informal and ad-hoc peer support, and had concerns about their skills in managing patients’ psychological needs. Conclusion: Community nurses benefit from attending AL2Gs to support them with their palliative care/end-of-life caseloads. It is recommended that all community staff involved in this type of care have access to regular clinical supervision, especially in a group format.

Caring for those who have palliative and end-of-life conditions has become a common aspect of community care (Public Health England, 2018; The King's Fund, 2022). More patients are requesting treatment at home, even into the active dying phases (Hunter, 2018). In an ideally staffed NHS, this would include access to a range of specialist palliative care services, including clinical health psychology (Hussain et al, 2016).

However, in reality, limited funding has resulted in large gaps in service provision, with a significant proportion of daily care, including psychological input, falling on non-specialist, general services, such as those provided by community and district nurses (Hussain et al, 2016; Hunter, 2018). District nurses, for example, are now seen as the most frequent and regular providers of hands-on palliative care and will visit patients with increasing frequency towards the end of life (Independent Cancer Taskforce, 2015).

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content