Gold Standard Framework for Palliative Care gets RCGP endorsement, UK

Main Category: Palliative Care / Hospice Care
Article Date: 20 Jun 2005 - 10:00 PDT

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Royal College of General Practitioners (RCGP) is to endorse the Gold Standard Framework (GSF) in Palliative Care, firmly embedding it into real life primary care.

The GSF is a tried and tested framework of enabling tools to help primary care teams deliver the best possible care , the 'Gold Standard' of care, for people nearing the end of their lives. This generic improvement tool was developed for primary care by primary care, initially for cancer patients, but now used for any patient with a life limiting illness in varying settings. It is now being used by almost a fifth of all GP practices in England, Scotland and Northern Ireland, with local GSF Facilitators in two thirds of PCTs.

The aim of the GSF is to develop a practice based system to improve and optimise the organisation and quality of care for patients and their carers in the last year of life. It embodies an approach that centres on the needs of patients and their families and encourages inter-professional Primary Care teams to work together to improve the way these are met. This work is underpinned by the best available evidence of key issues and effective solutions in this field, and at every stage there has been concurrent evaluation and research, with teams from Universities including Warwick, Birmingham, Sheffield, Huddersfield. Using GSF in the community can improve communication, advanced care planning and monitoring of patients, enabling more to die where they choose and reducing un-needed hospital admissions, thereby increasing cost effectiveness and secondary care capacity. Better communication and teamwork within primary care, and better collaboration with hospices and specialists in palliative care are also important benefits. Most find the overall quality of care is better, improving the experience of care for patients, carers and staff.

Dr Keri Thomas, GP with a Special Interest and National Clinical Lead for Palliative Care (generalist), was the originator of the work and now leads a Central GSF Team and the GSF Support Programme. "Care for the dying involves us all. It is also one of the best things we do in primary care. Within primary care we provide a large amount of care for those in the last years of their lives, and generally we do it well�but we can do even better. It can be one of the most satisfying and rewarding aspects of our work, and yet it is still challenging and, at times, stressful and disorganised. Use of GSF helps formalise and enable good practice, improves the consistency and reliability of care whilst focussing on the needs and choices of patients. Caring for those at the end of life fits the 'cradle to grave' ideal of general practice, affirms the importance of longer term relationships with our patients and should be a natural development of our ongoing work with patients with long term conditions"

A phased support programme with training, support, resources and audit ensures best spread and implementation of the framework. Future extensions of GSF includes its use in other settings such as Care Homes, for those with specific needs of non-cancer illnesses, increased use of Advanced Care Planning, developing focussed accessible education and a means to improve end-of-life care along the whole patient pathway.

Dr Graham Archard, RCGP Vice Chairman said "The College is pleased to support the Gold Standard Framework, which is having a huge impact on the quality of care at the end of patients' lives. The values expressed in this framework are central to the college ethos of knowledge with compassion.

More information about the Gold Standard Framework in Palliative Care can be found at http://www.goldstandardsframework.nhs.uk or email: info@goldstandardsframework.co.uk or contact the RCGP Press Office on 020 7344 3135/6/7 or email press@rcgp.org.uk.

It is recommended in the NICE Guidance on Supportive and Palliative Care, by the House of Commons Health Select Committee and the NHS End of Life Care Programme. http://www.modern.nhs.uk/cancer/endoflife Some PCTs incorporate it in their GMS2 Local Enhanced Services and Quality payments.

Dr Keri Thomas is GPwSI Palliative Care, Birmingham National Clinical Lead, Cancer Services Collaborative and NHS End of Life care Programme, Associated Clinical Director Community Palliative Care Birmingham, Macmillan GP Advisor, Clinical Senior Lecturer Warwick University.

The Royal College of General Practitioners is the largest membership organisation in the United Kingdom solely for GPs. It aims to encourage and maintain the highest standards of general medical practice and to act as the "voice" of GPs on issues concerned with education; training; research; and clinical standards. Founded in 1952, the RCGP has over 22,000 members who are committed to improving patient care, developing their own skills and promoting general practice as a discipline.

Promoting excellence in family medicine http://www.rcgp.org.uk

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