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Standard 2.1

Within service delivery, appropriate time is scheduled to allow for full discussion with the patient and their whānau about what matters to them.


Standard 2.2

Communication skills training is a core component of all healthcare workforce training.


Standard 2.3

Health care workers involved in difficult conversations, e.g. ‘breaking bad news’, have the required experience and skills.


Standard 2.4

Organisations have services in place to support health workers to reflect on situations of difficult communications (e.g. supervision, case review).


Standard 2.5

Interpreter services are available and health and support workers are skilled in their use.


Equity: Every consumer has the right to effective communication in a form, language and manner that enables them to understand the information provided.




Communication has been identified as being integral in the provision of quality supportive care. People affected by cancer require interactions where workers engage with them as a whānau as well as one to one. The person being spoken to needs to feel that the health and supportive care worker is engaged in the process, wishes to be asked questions and will take time to explain things in a way that can be understood.


A point of difficulty a person affected with cancer can have is how they are informed that they have cancer, that it is not responding to treatment or that the cancer has returned. Breaking bad news is a skill which must be obtained by those working in diagnostic and treatment teams. It has been shown that effective communication from the beginning of a person’s engagement with services enhances their interaction with and satisfaction of services. This includes ensuring that people being treated for cancer are orientated to the variety of diagnostic and treatment services they are going to engage with.


The Health and Disability Code of Consumer Rights identifies that “every consumer has the right to effective communication in a form, language and manner that enables the consumer to understand the information provided. Where necessary and reasonably practicable, this includes the right to a competent interpreter” (Health and Disability Commission, 1996).



“Take time, be good at answering

questions, make the patient know

you are interested in them and

their wellbeing.”

Cancer Stories Aotearoa –

Kahui Korero Taumahatanga o Te Mate Pukupuku



Good Practice Points



·        Services need to model good communication as this has been shown to reflect in how healthworkers respond to the people they are dealing with, i.e. ensure the organisational culture is one of respectful communication.

·        An effective way to improve communication is to allow staff to have opportunities to reflect on situations which have been difficult and that have either gone well or haven’t.

·         Service development needs to factor in time for meaningful dialogue between the person affected by cancer and their treatment team.

·        Services need to support training for health workers in cultural competency to increase their communication skills.

·        Services need to ensure health workers have knowledge in cultural protocols of communication and engagement.

·        Services need to ensure that methods of communicating, i.e. via text, email, phone and face to face, are appropriate and don’t increase potential inequities.

·        Communication styles need to be adapted to the age and developmental understanding of a person affected by cancer, with consideration of which methods are most appropriate.

·        Interactions need to be respectful of additional challenges that a person may face such as hearing loss or English as a second language.

·        Services should support and encourage ongoing training for senior staff to maintain their communication skills, including advanced training for staff involved in having difficult conversations.

·        Sufficient notice of upcoming appointments is required to enable people affected by cancer to have support people attend appointments with them.


Organisations should have in place approaches to ensure the breaking of bad news is handled well, including:


·        Before the person and their whānau attend the appointment ensure all information is present

·        A change in status should not be given over the phone unless agreed prior

·        Consideration as to who is invited to the meeting

·        Attendance of other professionals who the person affected by cancer considers supportive

·        Where possible a second health care professional, e.g. social worker, should be present

·        With permission, whānau are informed of the change and agree with the person who they would like to contact them next and when.


Good Practice Points System


·        Communications training is included as a core component of all health workforce training programmes.

·        Advanced communication training programmes are developed and promoted.



Interpersonal communication banner

·        Is able to engage in dialogue which encourages questions and clarification.

·        Is able to use interpreters effectively when required and can demonstrate good practice steps in these interactions.

·        Is able to communicate effectively in times of high distress for the person affected by cancer by being able to explain complicated information in a way that can be understood, and using a variety of mediums to reinforce the information given (written summary, information resources, availability for follow-up).

·        Is able to demonstrate Te Reo Me Ona Tikanga practices when caring for a person affected by cancer, including the use of karakia.

·        Is able to clearly communicate and explain the involvement palliative care and its purpose to meet the needs of the person affected by cancer and their whānau.

·        Demonstrates the use of plain language and terminology, where possible taking into account the age and sensory and developmental needs of the person affected by cancer.

·        Is able to communicate effectively with those from other services in a collaborative manner.


Training and Resources Available

·          He Kāhui Kōrero Taumahatanga o te Mate Pukupuku Cancer Stories ProjectAotearoa / New Zealand narratives of encounters with cancer.

·          Working with Interpreters.

·          A useful short video which considers the language we use in palliative care.

·          Improving cancer patient experience an easy to read guide.


Last Updated October 2016