Gold Standards Framework annual conference – a celebration of quality care

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Fifty care homes received awards from Alan Rosenbach, special policy lead at the Care Quality Commission, and a further 25 were recognised for the second time, three years after their initial accreditation. Almost half of all nursing homes have now completed the GSF Care Homes Training Programme.

Dr Rosenbach said: “At the Care Quality Commission we place great value on the work of the GSF, which has undoubtedly helped to drive up standards of palliative care in care homes. The vital importance of this to people approaching the end of their life, and their families, can hardly be overstated.

“GSF accreditation will shape the thinking of our new approach to inspection and regulation – a measure of the significance for this work. GSF accreditation can become a part of the inspection process.”

Representatives from the successful homes told the conference how GSF had helped transform the care they provide their residents. The manager of the Malthouse in Dorset said the GSF programme and accreditation process had helped staff feel closer to their residents and communicate more openly with them. 

“We feel our residents have welcomed the opportunity to discuss their end of life wishes. Some are clear about their wishes and some choose to have loved ones with them. We explore their worries and wishes. This is what GSF is all about; it’s about people – individual people – wonderful precious human beings.”

Two GP practices collected their awards from Dr Dennis Cox, the Royal College of GP’s representative on the Review Panel of the Liverpool Care Pathway.

Dr Susan Lawson of Hawthorn in Skegness and Dr Andrew Foster of Coastal in Morecambe described how the GSF Going for Gold programme and accreditation had helped them meet the challenge of a growing elderly population. Both practices showed a substantial increase in the number of patients on their palliative register, the number of patients offered advance care planning discussions, the number of patients with conditions other than cancer, and the number of carers offered support. At Coastal, this has led to a halving of the number of its patients dying in hospital and twice the number of people dying in their normal place of residence.

Dr Foster said: “We had a time bomb on our hands as the elderly population increases. GSF has driven palliative care up and made us more prepared to care for these people.”

Liverpool Care Pathway

Earlier Dr Cox told the conference why the review had decided to phase out the Liverpool Care Pathway (LCP). He said that he’d approached the review with “positive thoughts” about the LCP, having seen it work well in general practice, but went on to describe how his mind was changed: “The epiphany for me was when a group of junior doctors told us, ‘we can’t use it any more because people were saying they didn’t want to be LCPd’.” The issues were mainly in its poor use in some acute hospitals, he said, and particularly related to problems with hydration and poor communication with families. LCP used in care homes and primary care was generally thought to work well. He praised the work of GSF in the community, leading to earlier planning and better use of LCP.

The big question, Dr Cox said, was what would replace the LCP? Important additional features now were the requirement to have a named doctor at home or in hospital and a personalised plan for individual patients, starting much earlier. Anita Hayes spoke about the current NHS England group developing new guidance by early next year.

Expansion of GSF 

Professor Keri Thomas, clinical director of the National GSF Centre, reported on the expansion of GSF across a range of settings including acute and community hospitals. There was also an update on the next steps following the first GSF accredited hospices with plans for hospice support workshops. Interested hospices can contact GSF Centre for details. 

Mike Connolly of Wythenshawe hospital said that it was not difficult to work out that if hospitals had a role in identifying patients they could help prevent people falling through the net.

Elaine Deeming from Southport and Ormskirk Hospitals echoed this point saying: “We felt that by bringing GSF in to the whole hospital this would be the missing link. Now three to four years on and GSF is the norm – patients flagged up and recognised – staff understand what it means and act on patients wishes and needs.” This was further discussed in workshops on improving integrated cross boundary care – the GSF Centre currently has three such foundation sites and is working with its eight regional centres (five of which are hospices) to take this further.

Delegates also heard about the success of the first GSF Dementia programme, completed by 22 individuals via the centre’s virtual learning zone, and about the start of the third phase of training for domiciliary carers in Somerset. 

Additional workshops included a focus on compassion and kindness in the workplace led by John Ballett and Mark Thomas – and there will be further focus on these topics at the GSF ‘Values in Healthcare’ Conference in Stafford on 21 January.

For more information about any of the GSF programmes please go to the GSF website or call 01743 539170.

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