Primary Care Training Programme

1. First Stage GSF in Primary Care

Since 2004, GSF principles at Awareness or Foundation Level have been mainstreamed into general practice in the UK supported by the NHS End of life Care Programme through the QOF processes, with 95% GP practices now having a palliative care/GSF register and regular meetings to discuss these patients. We are the only country in the world to do this, it has helped many thousands of patients receive better care and it is a great start……….but there’s more to do.

2. Next Stage GSF in Primary Care - 'Going for Gold'

A decade on from this, now is the time to build on this good practice in the UK to consider all people in the practice population in the final years of life (about 1%) and further integrating other improvements in end of life care into mainstream practice as part of the Going for Gold GSF programme. This includes earlier identification of people with non-cancer conditions and from care homes (use of early alerting, coding, E-PIG, etc), better sharing of information (through locality registers), better communication with patients and families (through advance care planning discussions), better cross-boundary care to reduce excessive time in hospital and help people live well and die well where they choose.

“GSF has become part of the fabric of improving end of life care in this country and has made a real difference for thousands of patients and their families. But there is still a way to go, and I welcome this new drive towards greater and deeper use of GSF, and renewed efforts towards excellence in the Going for Gold programme”.

Prof Sir Mike Richards DH National Director End of Life Care 2009

The new Next Stage GSF Quality Improvement Training Programme is called Going for Gold and  builds on QOF Foundation Level GSF to support the NHS End of Life Care Strategy (2008).

Why do it?

GSF is the leading quality improvement programme for GP practices, building on GSF at QOF level, leading to next stage Going for Gold programme. This leads to significant improvements and coordination of care. Practices who attain enhanced level then progress to GSGF Accreditation and the Quality Hallmark Award for end of life care -endorsed by the Royal College of GPs.

How to do it? 

Practice based learning programmes – 6 one-hour modules over 6 months, plus the popular ‘GSF-in-a-day’ workshops. Individual practice or in groups.  Full resources with everything you need to do this plus evaluation and support.

What GSF improves? 

Earlier recognition of patients, better coordinated care in line with patients’ wishes, reduced  hospitalisation, more living and dying where they choose.

 

Examples of best practice - what can be achieved by practices

GP practices undertaking Going for Gold showed ...

  • Trebling of numbers of patients on Palliative Care Register (range 32-69%)
  • Trebling of non-cancer patients on Palliative Care Register (13-44%)
  • Quadrupling numbers with recorded ACP, DNAR etc (15-62%,14-60%)
  • Increasing numbers dying in usual place of residence (38-50%)
  • Carers assessment and bereavement protocols increased (3-60%, 9-68%)

For more details see our Accredited GP Practices Flyer

 

“(Doing Going for Gold) has been very worthwhile, it’s been a cultural shift for us, we are much more proactive. It would be hard to go back now – we’ve changed the culture of how we practice and I think ……. when we look back on the way we practiced before, it seems very old fashioned and unsatisfactory”

Dr Karen Chumley GSF Accreted practice Essex 2012 – now recruiting 42 further Essex practices.

Next Steps-

“GSF presents the vision but also the practical tools and resources to make it happen. Doing ‘GSF Going for Gold’ with our practices has been transformational - it really works.  It's like the difference between the Premier League and League Division Three”

Dr Peter Nightingale, GP Facilitator and RCGP End of Life Care Lead 

 

 

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