Author: levans; Julie Armstrong-Wilson
Date: 2012-10-30

“What it has helped us do is actually deliver better, more coordinated care, not just well intentioned care. We’re more skilled at symptom management and while delivering better end of life care can take more time, the rewards are great.”

GSF Primary Care Accreditation Flyer September 2017

The right care for the right person in the right place at the right time – every time

Congratulations to the 3 GSF Accredited practices receiving the
GSF RCGP Quality Hallmark Award endorsed by the Royal College of General Practitioners

First time Accredited GP practices
Rowhedge & University of Essex Medical Practice, North Essex
Exmoor Medical Centre, Somerset
Rosegarth and Siddal Surgery, West Yorkshire

Dr Nicola Hilton from Layer Road Surgery receiving the award for the practice in March 2017

“Gold standard care should be for everyone, whether you are elderly and frail or have an aggressive cancer, it should be the same for all. Every individual has the right to the same care. Because we are now identifying people earlier we are able to have conversations with them about the needs and wishes and then plan their care on that basis.”
Dr Paul Sawczyn, Rosegarth Surgery

“Going for Gold has been a fantastic platform for our practice team to improve and provide a high quality standardised of care for all of our Gold Patients. We provide all of our patients with Gold Folders that include information for carers as well as advanced care planning. We are now evolving further to include frailty as an important part of our Gold Patient List using appropriate scoring systems to identify these patients. We are also in the process of developing virtual and face-to-face clinics to ensure comprehensive reviews of our frail patients as part of our work to improve advanced care planning and avoid unnecessary hospital admissions”.
Dr Kelsey Boddington,
Exmoor Medical Practice

“There are now 2.8% of the practice population on the GSF register – equating to 108 patients and a lot of those are dementia patients. Each of these patients has a named GP. We call them priority patients and we have a white board in reception with names on so that the reception staff know exactly who is on the list, who their named doctor is and that their needs should be prioritised.” Dr Carolyn Richardson, Rowhedge Medical Practice

“I am finding the monthly meetings for our gold patients helpful. Having an awareness of patients situations helps me deal with relatives who may be struggling or wanting support or to talk when they come in. Their knowing we are aware of their family situation I think gives them the feeling we care more than perhaps was shown before we started this process. There have been some very positive remarks on end of life care provided which is heartening to think we can help make the process as peaceful as possible”. Practice nurse, Exmoor Medical Practice

For more information please contact info@gsfcentre.co.uk

GSF Primary Care Accreditation Flyer Round 6 - September 2016

Examples of Best Practice for GSF reaccredited care homes
Proportion of deaths in the home averaged 83% with 10 care homes having 100% home death rates, 16% in hospital, 1% died elsewhere, i.e., no hospital deaths in 10 reaccredited care homes.
74% of those residents were identified as being in the last weeks or days of life when they died.
All offered initial Advance Care Planning discussion and 98% recorded in their care plans.

“GSF has really helped us to have a good structure in place and given everyone in the practice the confidence to initiate what can be difficult conversations with people about where and how they want to be cared for and that means everyone feels more in control.” Dr Sally Giovanelli, of Macklin Street Surgery ,Derby

GSF Award winning programme

These practices received the Quality Hallmark Award, endorsed by Royal College of General Practitioners

Hospital quotes
“ Implementation of the GSF enables staff to have the right conversations with patients and relatives and introduce the idea of advance care planning on what choices around their personal wishes and preferences, and aspects of care they do or do not want at this time in their lives.” Tricia Atkinson RLI
“ Improved cross boundary communication, when the patient comes into hospital we know what the patients preferences are and we can explore if that is still the case, work with patients and families to ensure care is delivered to the gold standard of care they want keep patient in the driving seat so that they understand expectations and potential outcomes of treatment available “
Alison Scott RLI

The GSF training has helped to move us to a completely different place. Before we started the GSF training we noticed that a significant number of people were being sent to hospital inappropriately and were not experiencing the care they would have liked. Now patients have a genuine choice about where they would like to be cared for. People are now confident not just that they’ll be asked what they want at the end of life, but that it will happen, so they can die peacefully at home with their families, if that’s what they want.” Dr Damian Patterson, Abbey View Medical Centre, Shaftesbury

Screening utilising the Gold Standards Framework Prognostic Indicator Guidance in the acute setting could be the first step towards implementing a more systematic way of addressing patient need - both current unrecognised and future anticipated - thereby improving outcomes for this population
O'Callaghan A et al Palliat Med. 2014 May 22. pii: 0269216314536089.

What is the GSF Going for Gold Programme and Quality Hallmark Award? The GSF Primary Care Training Programme ‘Going for Gold’ is a practice based quality improvement programme for primary care teams, that enables improvements in care for all people nearing the end of life. For more details contact info@gsfcentre.co.uk

Two Year GSF Support Programme Phase 5
Deadline for applications July 30th
First Workshop Sept 11th Birmingham

Demonstrating that embedding GSF Going for Gold in primary care delivers sustainable improvement!

Dr Jacqueline McKenna, MBE - NHS Improvement,

“Screening using the Gold Standards Framework Prognostic Indicator Guidance in the acute setting could be the first step towards implementing a more systematic way of addressing patient need - both current unrecognised and future anticipated - thereby improving outcomes for this population“ O'Callaghan A et al Can we predict which hospitalised patients are in the last year of life? Palliat Med. 2014 May : 0269216314536089.

Congratulations to the 30 nursing & residential homes, first accredited in 2011 and successfully reaccredited in 2014, receiving their awards today and to the 14 nursing and residential homes who have been successful in their first accreditation award, all presented by Amanda Cheesley, RCN.
They demonstrate the high standards of end of life care that can be achieved by care homes.

Dr Nicola
Layer Road Surgery receiving the award for the practice in March 2017

What's special about the GSF Programme in hospital?
It is a step by step programme with 2 year support, and everything required to support local implementation
GSF includes all stages across the full patient journey from admission to discharge or death, so will meet all CQC inspection assessments, NICE and CQUIN targets in line with the GMC definition of EOLC
The GSF framework comprehensive approach includes many tools that complement the NHS Transform programme, including early identification, clinical assessment eg use of Amber Care Bundle , personal assessment, Rapid Discharge , improved discharges, better after-death care and in bereavement .
GSF supports better integrated care with the community
It encourages compassionate care, enabling a deeper level of culture change - Head, Hands and Heart

Key achievements of GSF accredited practices
Identifying more patients earlier for their register and team discussions
Offering most of these patients advance care planning discussions
Reducing admissions and deaths in hospital
Enabling more to live and die well , where and how they choose
OR?? to add cumulative graph for
Summary of KOR ?? Julie Ithink or increased ACP

“GSF has made all of our staff, including the domestics, feel more confident about having difficult conversations with our residents and their families about the care they want and where they want to be cared for. This means we are now always prepared and can avoid crises and unnecessary hospital admissions, making the last months of their lives as valuable as possible. We are very proud to have received the GSF award and it’s down to the hard work and dedication of the whole team.”
Deborah Judd, Training Manager, Chelston Gardens Care home - GSF Reaccredited

Improving Cross Boundary care using GSF as a ‘common vocabulary‘
GSF helps to develop a cultural change that enhances Cross Boundary Integrated Care management by using a common language with all providers of care
GSF in hospitals links closely with its use across primary care homes, community hospitals domiciliary care and other areas ensuring integrated care focussed on the patient wherever they are
“ GSF has given is a common vocabulary in all settings– and that’s been a great benefit in our area “ Dr Karen Groves Palliative care Consultant Southport and Ormskirk Hospital

Reduced length of stay by average 3 days, some 13 days - 2014 Phase 3

Dr Jacqueline McKenna, MBE - NHS Improvement,