Across all themes the process of managing identity changes emerged as a key issue for parents, which needs to be considered. During treatment, health professionals have an opportunity to discuss the impact of finishing treatment and prepare parents for this transition and the challenges that they may face.

Providing home care to children with complex physical health needs is an emotionally challenging role. Extant literature and documents such as the Cavendish Review (2013) have reported that a large proportion of care for this population is carried out by non-registered staff (support workers). Provision of clinical supervision for nurses working in palliative care is increasing, however, supervision needs of support workers are commonly neglected. This paper sought to synthesise what is known about clinical supervision practices for support workers in paediatric palliative care (PPC). A literature review was conducted in accordance with integrative review guidelines. 315 papers were identified initially, 15 studies were included in this review. Four commonalities were identified: importance of team cohesion, varying degrees of formality, self-awareness and practicalities. Support workers received varying forms of supervision and some facilitators faced organisational difficulties involving staff in supervision. Support workers who received staff support generally appreciated it in recognition that their work is complex and emotionally difficult. This paper highlighted that further research should investigate the efficacy of clinical supervision as a method of reducing stress and burnout for support workers. Any implementation of supervision should involve a considered approach to training and supervision to ensure fidelity.

The NHS policy in the UK recommends that the built hospital environment should cater for the needs of younger and older children, adolescents and carers. However, previous studies have indicated that addressing the needs of such a wide age range is a challenge, and that the hospital design and systems are typically more appropriate for children of a younger age rather than adolescents. The aim of the present study was to explore how adolescents, who had not been regular patients, experience the hospital environment and their interactions with staff. Using qualitative methodology, we explore the responses of four young individuals who participated in an innovative filmed hospital intervention study documentary. Results suggest that a pediatric ward designed specifically for adolescents was experienced positively by participants. Other areas of the hospital serving a wide age range of patients (e.g., the emergency and radiography departments) were not experienced as positively. Implications for hospital design, staff training and future research using multimedia approaches are explored.

Support workers represent a large proportion of the NHS workforce and yet their supervisory needs are often overlooked. This study focused specifically on a cohort of support workers in a community paediatric palliative care setting. Peer supervision was implemented for this group, initially face to face and then virtually. The experiences of clinical supervision for this group were investigated through responses to an online survey ( n = 25) and two focus groups ( n = 7). Survey data were analysed concurrently with a thematic analysis. The following themes and sub-themes were developed from transcribed focus groups: (1) Barriers to engagement (2) Being Listened to (3) What Worked Well: Logistics. Overall, delivery of supervision was effective to a mixed degree – though support workers appreciated a space to be listened to, their distrust of colleagues and other barriers impeded the capacity of supervision to achieve more than support and catharsis for this group. Future projects should focus on introducing more preliminary interventions to promote reflection and peer support for these groups as well as continue to consider the supervisory needs of support workers.