End-of-life strategy urges greater QOF role

An RCGP end-of-life care strategy launched last week hands GPs a key role in a radical upgrade of patient services.

Recommendations include greater integration with the quality framework, more GP involvement in care homes and better out-of-hours palliative care (see box).

Author of the report Professor Keri Thomas said end-of-life care was part of the core business of general practice but new challenges meant that a more consistent, systematic approach was required.

Changing demographic profiles and illness patterns, with longer end-of-life and dying stages, meant current health and social care services were ill prepared to fully meet patient needs, she said.

'Despite recent developments and many areas of good practice, patients still face a lottery of inconsistent, sometimes suboptimal care. No one is better suited to provide excellence of care than the GP and the primary care team.'

The RCGP has set up an end-of-life care working group for three years to develop and implement policies relevant to all four UK nations.

Professor Thomas, the RCGP clinical champion in end-of-life care, said the strategy would aim to build on the current Gold Standard Framework, refine educational resources, support research and strengthen teamworking with nurses.

'Care of the dying is a litmus test for the health service, and challenges general practice to respond with the best that the profession has to offer - clinical expertise, considered professionalism, personalised care and human compassion.

'The holistic role of the GP is poised to come into its own in a way never encountered.'

Key points

  • Build on the Gold Standards Framework (GSF)
  • Integrate GSF principles and activity within quality framework
  • Integrate end-of-life care into all GP learning
  • Greater involvement of GPs and GPSIs in care homes
  • Advanced care planning to become routine
  • Improve out-of-hours palliative care

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