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Practice nurses called on to adopt standards for end of life care

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GP surgeries can now display a “daffodil mark” as a sign of commitment to improving end of life care, as part of a new partnership between the Royal College of General Practice and the charity Marie Curie.

The mark, synonymous with the charity, is based on a new set of criteria called the Daffodil Standards.

“Nurses play a vital role in providing person-centre and effective end of life care to people”

Julie Pearce

They are a set of eight quality improvement statements designed to support primary care teams deliver care to patients living with an advanced, serious illness or at the end of their lives.

By adopting the Standards, GP practices commit to making improvements in at least three of eight core aspects of care each year, with the aim of having reviewed all of them after three years.

The eight Daffodil Standards are:

  1. Professional and competent staff
  2. Early identification of patients and carers
  3. Carer support - before and after death
  4. Seamless, planned, co-ordinated care
  5. Assessment of unique needs of the patient
  6. Quality care during the last days of life
  7. Care after death
  8. General practices being hubs within compassionate communities

The standards have already been recognised by the new Quality and Outcomes Framework on end of life care, which forms part of the GP contract, and the Care Quality Commission.

In addition, they have been piloted by a number of surgeries across the UK, and each standard comes with its own evidence-based tools, exercises and quality improvement steps.

Julie Pearce, director of nursing and quality for Marie Curie, said: “Nurses and allied health professional staff play a vital role in providing person-centre and effective end of life care to people.

“The beauty of the Royal College of GP and Marie Curie Daffodil Standards is that they’re designed to bring everyone together across the GP practice to talk about and to plan a better way of co-ordinating care,” she said.

“Staff find it hugely rewarding when things go well for patients and they feel better able to support families,” she added.

“The pilot practices have found that by spending about four to five hours per month together using the standards and improvement materials that they have been able to make significant and measurable improvements,” she said.

“Making sure that patients and their families feel supported at the end of life is an essential part of what we do”

Helen Stokes-Lampard

She highlighted that the emphasis was on “continuous quality improvement, learning and problem-solving together and involving patients and carers in their journey”.

To coincide with the launch, a survey found 62% of GPs disagreed there were enough community resources to give families and carers of terminally ill or dying patients the emotional support they need.

The standards fall back on the fundamental values of general practice being hubs within “compassionate communities”, which includes considering staff emotional support needs after their patients die.

According to the survey, 71% of GPs agreed there should be more resources available to help GPs and practice staff with the grief of losing patients, with just 2% saying their practice held formal support sessions on dealing with grief and loss.

helen stokes lampard blog image

helen stokes lampard blog image

Helen Stokes-Lampard

In addition, 59% said that their practice did not organise ways for the staff to share stories or get support for dealing with grief and loss.

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, added: “Making sure that patients and their families feel supported at the end of life is an essential part of what we do.

“We’re delighted to be able to launch these standards with Marie Curie and hope they go a long way in supporting GPs, their teams, and, of course, our patients, but current pressures on our service and the effects they are having on our ability to consistently provide high-quality palliative care cannot be ignored,” she said.

“That’s why it’s essential that the pledges for more investment for general practice and for more GPs and practice staff, made in NHS England’s GP Forward View and the NHS long-term plan are delivered urgently and in full,” said Dr Stokes-Lampard.

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