Palliative care starts from the understanding that each human being is a person, a single bodily and spiritual whole, and the proper response to a person is respect. Respect means being so open to each man, woman and child, not as simply an isolated individual, but as someone with a story and a culture, with beliefs and relationships, that we give them the value that is uniquely theirs.
Dame Cicely Saunders.
The National Gold Standards Framework Centre (GSF) runs training and support programmes to help GPs and district nurses as well as all care home staff provide the highest possible standard of care for all patients who may be in the last years of life.
GSF involves the primary care team, (your family doctor and district nurses) or care home staff, working together with you and with other professionals involved in your care. The aim is to improve the organisation and quality of care for everyone in the last years of life whatever their age or illness.
Patients with advanced disease deserve the best care - the 'gold standard' of care. That means high quality, reliable and consistent support.
GSF encourages doctors, nurses and care home staff to help families and carers too, so they can work together to avoid 'crises' and prevent patients having to go to hospital when it is not essential. Better planning of patients' care means a last minute prescription panic or something more major can be averted.
The views and ideas of patients and carers have been used in the development of the Gold Standards Framework and will continue to influence what we do.
The National Team would like to work more closely with patients, families and carers, with new resources and support. Contact us if you are interested in supporting this work or learning more.
The National GSF Centre does not offer direct help to individual patients and families, we recommend contacting your own surgery or district nurses to find out where you can get help locally.
How GSF works in primary care
GPs and the district nursing team identify patients who they believe are in the last year of their life. The patient will then be placed on a palliative care register. Some surgeries know these patients as gold patients, ensuring all staff know who they are, their condition and make every effort to ensure their calls are given priority.
Their condition will be continually assessed and their care planned. Planning a patient's care is the key. It's done in consultation with the patient - the aim is to ask a patient what kind of care they would like and where they would like to receive it. These preferences are then recorded and passed on to other medical professionals including out of hours doctors who don't know the patient personally.
By coordinating, assessing and planning a patient's care in this way doctors and nurses can avoid admitting a patient to hospital when it is not essential and can enable the patient to be cared for and to die in their chosen place wherever possible.
How GSF works in care homes
Almost 1500 care homes across the country have now completed the GSF Care Homes Training Programme and 150 are now proud owners of the Quality Hallmark Award recognising the high standard of their end of life care.
In practice this means that residents of these homes can expect excellent care. Many GSF homes will seek to plan a resident's care as soon as possible after they move into the home. Residents, and often their families too, will be asked what kind of care they would like and where they would like to receive it. These preferences are recorded.
The training programme has helped care home staff feel more confident about looking after residents at the end of their lives. Staff in these homes work effectively with GPs, nurses and local ambulance staff, communicating regularly, coordinating a resident's care. This planning process, based around a resident's wishes, means that crises can be avoided and unnecessary and unwanted admissions to hospital are averted.
A number of care homes have found that since they completed the GSF programme they have doubled the number of residents dying in the home rather than in hospital - meeting residents' wishes.
How GSF works in hospitals - coming shortly
You matter because you are you. You matter to the last moment of your life. And we will do all we can, not only to let you die peacefully but to help you to live until you die
Dame Cicely Saunders, Founder of the Modern Hospice Movement
