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Primary care urged to implement new end-of-life guidelines

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Primary care services will face an ‘avalanche of need’ among dying patients if they do not act now to improve end-of-life care, a leading expert in end-of-life care has warned.

This week sees the launch of the latest version of the Gold Standard Framework (GSF) for Primary Care, a set of tools and resources that can be adapted within GP practices and community nursing teams to improve end-of-life care for patients at the end stage of any illness. 

Speaking at the launch of GSF Primary Care Next Stage – Going for Gold, professor Keri Thomas, national clinical lead for the GSF Centre for England, said that unless end-of-life care was improved over the next three years, the needs and wishes of thousands of patients would go unmet.

In 2005, 512,000 people died in England. According to government predictions, this figure is set to rise to 585,000 by 2030 – an increase of 17% – with deaths outnumbering births for the first time in the country’s history.

‘The next three years are crucial for primary care if we are to ensure that we can deliver a gold standard of end-of-life care for all who need it by 2012 – the start of the upturn in deaths and looming avalanche of need awaiting us,’ said professor Thomas.

‘GSF enables improved coordination and communication, with greater focus on the needs and preferences of patients and their carers, which in turn leads to fewer crisis hospital admissions, and more people living and dying where they choose,’ she added.

The original GSF was developed in 2001 to provide a structured framework for quality end-of-life care. The programme has since been further developed into three distinct parts - primary care, care homes and end-of-life support.

The patient-centred framework can be used by clinicians to identify patients who are in the last year of life, assess their needs, symptoms and preferences, and plan care based around enabling them to die where they choose.

It has been shown to improve the quality of care provided, and to significantly reduce unnecessary hospital admissions and deaths. Its use was recommended in the government’s 2008 End of Life Care Strategy and is also being backed by the Royal College of GPs, the RCN and NICE.

The GSF Primary Care Next Stage – Going for Gold – is a revised and updated part of the primary care section of the framework to help primary care practitioners meet the needs of dying patients in view of the predicted upcoming pressures on services.

The result of an extensive review of the current programme, it draws on latest thinking and includes new ideas, tools, training programmes and resources to help practices improve and update their care for end-of-life patients.

The GSF Centre is also developing support packages for trusts and practice teams to help them implement the updated programme, and is launching a campaign to raise public awareness of end-of-life care.

RCN primary care adviser, Lynn Young, said: ‘Nurses play a significant part in the care of people who are at the end of their lives, regardless of the setting in which care is being provided, and we welcome the opportunity to contribute towards achieving a universal gold standard for all.’

National cancer director Professor Mike Richards, chair of End of Life Care Strategy Advisory Board, added: ‘I welcome this new drive towards greater and deeper use of GSF, and renewed efforts towards excellence in the Going for Gold programme. Primary care needs to embrace GSF further if we are going to deliver the quality care patients deserve.’

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Readers' comments (1)

  • the biggest REAL need is the for 24 hour 'hands on' nursing care for EOLC especially the dying phase.

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