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Welcome To The

No Conversation Too Tough Training Programme

Our training programme, No Conversation Too Tough, equips healthcare professionals (HCPs) with the skills, knowledge and confidence to support parents with an incurable cancer diagnosis to have challenging conversations with their children about death and dying.

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Our No Conversation Too Tough training programme is a free, CPD-accredited course for HCPs who work with families where a parent has been told that their cancer is incurable. The aim of the programme is to enable HCPs to support these families, by empowering patients to have honest conversations about death and dying, so they can better prepare their children for what is to come.

Who is the programme for?

The programme is designed primarily for cancer nurse specialists and palliative care nurses. But we welcome other HCPs working in any discipline involving pre-bereavement support or where the themes and topics might be relevant. 

What is the programme’s format?

There are two elements to the programme: a pre-course e-learning unit and a one-day workshop. The e-learning takes around two hours to complete and provides a solid foundation for the theories and practice explored in the workshop. The workshop is held over a full day, from 09:30 to 16:30. You must complete both elements to receive a CPD-accredited certificate (approximately 8 CPD points in total).

Where and when is the training held? 

You can complete the e-learning in your own time before you attend the one-day workshop. Workshops are held at various locations across the UK to ensure healthcare professionals from all regions have an opportunity to attend. In some circumstances we can subsidise travel to attend a course, based on assessment of individual need. Contact us to find out more. We can also come to your place of work to deliver the training onsite to whole teams. Get in touch for more information.

We plan to hold a monthly online training workshop for delegates who live and work abroad or cannot attend in person for other reasons. If you’d like details about remote training, just ask.

Where and when is the training held? 

The No Conversation Too Tough training programme is run and funded by the Ruth Strauss Foundation.

The one-day workshop is delivered by two highly experienced facilitators; one has a background as a clinical nurse specialist and the other has extensive expertise in child and family bereavement.

Learning Objectives

On completion of the training programme, you will understand:
  • The broad context and need for this training
  • The relevance of grief theory with regards to the impact of a parent’s death on children
  • The multiple and complex family factors that make a personalised family approach
  • Necessary best practice with regards to documenting the presence of children in a family unit.
You will have the skills to:
  • Assess the family structure, dynamics and readiness to discuss dying and its impact on the family unit
  • Confidently apply a framework locally for multidisciplinary teams to guide conversations with families
  • Use a range of resources, techniques and tools to facilitate sensitive conversations
    draw on your own life experiences and resources and build resilience through ongoing peer support.

Ruth’s Legacy…

When Ruth Strauss was diagnosed with incurable cancer, she and her husband Andrew found there was a woeful lack of emotional support to help them talk about Ruth’s prognosis with their children.

She was determined to change that. Every day in the UK, around 127 children are bereaved of a parent. While there are several organisations that provide bereavement services after a parent has died, there is a gap in provision of similar support for families where a parent is coming to the end of their life.

Evidence suggests that when children facing a parent’s death can talk openly at the pre-bereavement stage, they are better able to deal with their grief [where is this stat from?].
We know that healthcare professionals – nurses, in particular – play a crucial role in helping parents to have sensitive, honest conversations with their children about death and dying.
That’s why we developed the No Conversation Too Tough training programme.

Ruth was determined to ensure that others going through what our family had encountered should have a support network available to help them navigate their way through their illness and help prepare the whole family for the death of a parent. She wanted people to ‘do death well’.”

Andrew StraussRuth’s Husband & Founder

We make a difference

Measuring the success of our training programme

Researchers from the University of Surrey independently evaluated the pilot and published their findings in May 2022. Feedback from delegates who took part in the evaluation was overwhelmingly positive. The evaluation demonstrated that:

We developed the No Conversation Too Tough training programme alongside a panel of experts and people with lived experience of the death of a parent.  

The one-day course was piloted among palliative care nurses and clinical nurse specialists who care for people with incurable cancer in hospices and community and acute settings.

To date, we have delivered the training to over 263 delegates. Here, you can continue discussions on our online forum, share experiences and best practice and access expert-led masterclasses and our hub of resources. 

  • The course exceeds delegates’ needs and expectations in respect of improving practical skills, knowledge and confidence
  • The content is robust and relevant to delegates’ roles and requirements
  • The learning translates into valuable and usable practice behaviours.

What makes our training programme different from others is that we focus on pre-bereavement – that period between receiving a poor prognosis and the end of life – which can last days, weeks, months or even years.

Previous Attendeevia RSF Training Programme

Our goal is to help children and families to come to terms with the prospect of a parent dying. We do this by enabling nurses to support and empower parents to have those difficult conversations rather than working directly with children.

Previous Attendeevia RSF Training Programme

Something I took away was recognising that I am not able to fix the situation, but I can offer support to patients and families.

Previous Attendeevia RSF Training Programme

It’s OK to not skirt around the ‘death’ word. We need to stop making it look fluffy because it’s not fluffy. There seems to be more and more of these conversations needing to happen with younger and younger children. Thank you for this opportunity.

Previous Attendeevia RSF Training Programme

Register Interest

Complete The Form Below

  • We are extremely fortunate that the University of Surrey is conducting an independent evaluation of the national roll out of the ‘No Conversation Too Tough’ training programme. The research is looking at how the training benefits Health Care Professionals in their conversations with patients who are dying and who have dependent children, and more widely how it will be implemented in practice. We hope that you will be interested in taking part and will find participation both beneficial and rewarding. If you are happy for the Ruth Strauss Foundation to forward your contact details to the University of Surrey please give your permission below.
  • We will only use your information to administer and manage the training programme and to keep records. If you register but do not attend the one-day workshop, we will keep your details on our system for two years, so we can let you know about future training opportunities.
    We will be in touch from time to time with news, updates & ways you can support our work, including opportunities to donate, volunteer and fundraise. Clicking submit confirms that you’re happy to receive emails from the Ruth Strauss Foundation. We take your privacy very seriously and promise to keep your details safe. Check our privacy policy to find out more.


We’ve put together a collection of handouts, reading materials, and other tools that complement the No Conversation Too Tough training programme.

We’ve put together a collection of handouts, reading materials, and other tools that complement the No Conversation Too Tough training programme.

Some of the resources are designed for patients, while others are for healthcare professionals to use in their practice. You can access these resources and download them free of charge and share them with colleagues, peers and, where appropriate, patients and families.

We hope you find them useful.

Order our resources today by clicking the link below.

Order Resources


Marshall et al, 2021 (PDF)

The perspectives of children and young people affected by parental life-limiting illness: An integrative review and thematic synthesis

Aim: To synthesise and appraise the literature from primary research with children about their experience of having a parent with a life-limiting illness.

Cockle-Hearne et al, 2020 (PDF)

The dying parent and dependent children: a nationwide survey of hospice and community palliative care support services

Aim: To determine the bereavement support provided to families with dependent children by UK hospices before and after a parent’s death.

Franklin et al, 2019 (PDF)

Health and social care professionals’ experiences of supporting parents and their dependent children during, and following, the death of a parent: A qualitative review and thematic synthesis

Aim: To systematically identify, analyse and synthesise literature reporting of the experiences of health and social care professionals when supporting parents and children during, and following, the death of a parent.


External Resources

The Talking, Telling and Sharing Framework: End of Life (PDF)

A simple, evidence-based framework to open conversations with parents and help them to think about communicating their prognosis with their children. Courtesy of Family-Centred Cancer Care

10 tips to help parents and carers with a life-limiting illness have conversations with their children – a guide for professionals (PDF)

A clear and useful resource to help healthcare professionals to support parents to talk about death and dying with their children. Courtesy of Marie Curie


RSF Resources

Navigating Children’s Grief – how to help following a death (PDF)

A handy, at-a-glance resource outlining how children of different ages respond to grief and age-appropriate ways to help them

Mission video – Here for families facing grief (video)

A short video introducing the Ruth Strauss Foundation’s support for families

Children, young people and family pre-bereavement support services

A list of organisations providing support services and resources for children, young people and families facing death and bereavement


Resources for Parents & Patients

This is about me and you (PDF)

An interactive workbook and accompanying guide for parents to read and work through with their children (aged around 4 to 14), to help communicate difficult information when a parent or carer has a terminal illness.

You can order printed copies of this pack free of charge for use in your practice. There is a limit of 5 copies per order, but you can place more than one order. Order for free here.

10 Support Steps: Speaking to your child about an incurable illness (PDF)

A brief overview of how parents can approach talking to their children about death and dying

Little C Club x Ruth Strauss Foundation Flashcards

A set of flashcards designed to help parents have inclusive conversations with their children about a diagnosis, treatment, emotions and more. Created in collaboration with the Little C Club. Order the Little C Club x RSF Flashcards for free here.

Order Now