Acute wards in Exeter and Lancaster have become the first in the UK to be recognised for their care for patients nearing the end of their lives by a gold standards framework supported by regulators.
Two wards at Royal Devon and Exeter Hospitals NHS Foundation Trust and one at University Hospitals of Morecambe Bay NHS Foundation Trust are the first to receive the National Gold Standards Framework Centre’s (GSF) quality hallmark award in end of life care.
All three wards were praised for improving the quality of care for all patients towards the end of life and “crucially” for enabling more to live and die at home if they chose.
“Achieving this accreditation is a testament to the hard work and dedication of all the staff”
Yeo and Yarty wards at Royal Devon and Exeter – oncology and haematology wards, respectively – and Ward 23 at Royal Lancaster Infirmary – a stroke ward – provided evidence of measurable change to the way they organised care and its positive impact on patients, relatives, carers and staff.
Accreditors said they demonstrated early recognition of decline – with more than a third of patients identified as being in the final year of life – offered advance care planning discussions to all and improved communication with GPs, meaning patients were discharged where appropriate.
For example, on Yeo ward, 57% of patients are being identified as in the last year of life, which has helped staff initiative conversations with patients, so care can be planned in line with their wishes.
Em Wilkinson-Brice, chief nurse and chief operating officer at the Royal Devon and Exeter, said: “Achieving this accreditation is a testament to the hard work and dedication of all the staff and end of life teams… who daily provide safe, high quality and compassionate care for our patients.”
Staff from the two hospitals received their awards from Professor Sir Mike Richards, chief inspector of hospitals at the Care Quality Commission, who urged others to follow their example.
“We know that many hospitals struggle to identify patients in the last year of life and consequently find it difficult to coordinate their care adequately,” he said.
“The gold standards framework enables better care for people in the last months of their life,” he said. “These hospitals should be congratulated for leading the way and being exemplars for others to follow.”
The GSF accreditation for acute hospitals is endorsed by the British Geriatric Society, which also took part in the assessment process.
Dr Martin Vernon, the society’s end of life care lead, said the wards’ achievement was a “milestone event”.
“Staff on the wards that have been accredited will feel more empowered to provide the coordinated care this most vulnerable of patient groups require,” he said.
“We hope others will aspire to this standard, as others have in primary care and care homes”
Professor Keri Thomas, GSF national clinical director, highlighted that end of life care was “one of the biggest challenges” facing the acute hospital sector.
“By implementing a structured systematic approach – with earlier recognition, improved communication with patients and fellow professionals, and better coordinated care – it is possible to provide a quality of care for people in the final year of life wherever they are,” he said. “We hope others will aspire to this standard, as others have in primary care and care homes.”
The Gold Standards Framework Centre started in 2000 in primary care and now runs GSF programmes in end of life care in all settings.
The two hospitals are among more than 40 to have completed GSF Acute Hospitals Training, a two-year programme aimed at helping generalist frontline staff better recognise patient decline and comply with their preferences.