End-of-life care will become an additional category that feeds into the overall rating each GP practice receives, under plans set out by the CQC in a report addressing inequalities in end-of-life care across the health service.
Practices currently receive individual ratings from ‘inadequate’ to ‘outstanding’ on their care for groups of patients including older people, those with long-term conditions and families, children and young people.
Although the CQC assesses end-of-life care in GP practices and adult social care services, they do not currently receive a specific rating for this – whereas hospitals, community health services and hospices do.
The CQC said bringing GP practices in line with other organisations on this would allow for a more ‘consistent’ approach across services and make it easier for end-of-life care to be compared across health sectors.
The report said: ‘In services that provide end-of-life care but do not currently receive a specific rating, including adult social care services and GPs, we will include an assessment of the quality of end-of-life care and whether it is meeting the needs of different groups.
‘In GP assessments, we will assess whether the service is ensuring early conversations and coordinated end-of-life care for people from different groups.’
The CQC says it expects GPs to ensure that all patients with life-limiting progressive conditions have access to ‘easy and ongoing conversations’ about end-of-life care.
GPs should also make sure that patients are assigned a named care co-ordinator – a lead professional who coordinates services around them. This could be the GP, district nurse, specialist nurse or any other professional most appropriate to the patient’s needs.
The CQC report found that one in three CCGs had not assessed the end-of-life care needs of their local population.
Among the 67% which had, only 18% reported that they commissioned specific services for at least one of the population groups considered in the review, something the CQC said must improve.
The population groups include people whose social circumstances make them vulnerable, older people, people with dementia, a learning disability, a mental health problem, or a chronic progressive illness other than cancer.
GP palliative care
Professor Steve Field, CQC’s chief inspector of general practice, said: ‘While we know there are hospitals, GPs, care homes, hospices and community services across the country that are providing good and even outstanding care to people at the end of their lives, one person that does not get this is one person too many.’
RCGP’s Dr Catherine Millington-Sanders, also a Marie Curie clinical champion for end-of-life care, said: ‘There is no denying that GPs play a central role in delivering palliative and end-of-life care to their patients, and their families.
‘With our ageing population, and as the number of deaths increase in the future, GPs and our teams will need additional time and support in order to provide the high quality care our patients deserve at an incredibly vulnerable time in their lives.
‘NHS England’s recent GP Forward View was a statement of faith in our profession and the care we deliver to patients from the beginning to the end of their lives, and we very much hope that some of the new funding will be used to enhance end of life care in the community, close to home, where most patients at or nearing the end of their life want to be cared for.’