Breaking News

Breaking difficult news is an essential part of the pathway for the children with exceptional healthcare needs because it is often a recurrent feature in the lives of these children and their families and this process might be revisited at a number of stages in their lives.

Most parents acknowledge that this is the most difficult time for them to deal with. Respect should be given to the need for parents to deal with difficult information in their own way and time. The following principles may help:

• Who is the most appropriate to break the news (hospital staff/community staff)?
• Be honest and open, remain professional but compassionate as the breaking of such news will be a lasting memory for the family
• Try, if possible, to speak with both parents together and ask if the parent wants another person there for support
• Prepare the physical environment, e.g. privacy, less formal, no interruptions
• Have the baby / child present, if possible
• Use as simple language as possible, assess how much the parents or carers can understand e.g. language barriers, learning difficulties, communication difficulties
• Give good information (do your homework) but admit if you don't know the answer to a question
• Have details of any resources to hand (websites/information packs, support groups, contact personnel)
• Have another person working already with the team with you ? to be available to the parents to go over what was said
• Limit the professionals to those really necessary e.g. families may be overwhelmed by numbers present
• Be available to answer further questions. Sometimes questions already asked need answering again
• Allocate a date /time for a follow-up session , allow time for the family to take it all in
• Record a summary of the session with details of the news given and the family response

Useful web sites:

• http://www.act.org.uk/
• http://www.dsscotland.org.uk/professional/breakingthenews
• http://www.skillscascade.com/badnews.htm

Useful documents:

• Framework for Sharing Significant News (July 2010, Scottish Children and Young People Palliative Care Network)
• Breaking Bad News Regional Guidelines (February 2003, Northern Ireland)
• Guidelines on the Breaking of Bad News (March 2010, NHS Yorkshire)
• Informing Families of Their Child's Disability-National Best Practice Guidelines (2007, Ireland)
• Good Medical Practice in Paediatrics and Child Health (May 2002, UK)
• Right from the start, sharing news (Scope. About cerebral palsy)