Viewpoint: End-of-life care in care homes goes well beyond COVID-19

Best practice standards for GPs and teams caring for older people in care homes - developed by the RCGP and Marie Curie - offer a manageable approach to improving end of life care that will remain relevant beyond COVID-19, says end of life care champion Dr Catherine Millington-Sanders.

RCGP/Marie Curie national clinical champion for end of life care Dr Catherine Millington-Sanders
RCGP/Marie Curie national clinical champion for end of life care Dr Catherine Millington-Sanders

Our patients who live in care homes are some of our most vulnerable, and GPs and our teams play a key role in ensuring they have the best possible quality of life right up until the end of their lives.

For me and for many colleagues I speak to and who get in touch this is a hugely rewarding, if challenging, aspect of the job.

Evidence shows that well-planned end of life care makes the lead up to death less traumatic for both patients and their loved ones.

End of life care

Designed by GPs and other multi-disciplinary healthcare professionals, including those working in the care home sector, this new set of standards - ‘Daffodil Standards for older people in care homes’ - will support GP teams as they care for older patients who live in care homes at or approaching the end of their lives, including those affected by advanced serious illness.

While there’s no doubt that this pandemic has shone a light on the importance of the care older patients in care homes receive, this has always been important, and the RCGP has been working with Marie Curie to develop these new standards since before we’d heard of COVID-19.

They build on the original Daffodil Standards, launched in 2019, which aimed to support GP practices to deliver the best possible palliative and end of life care at a community level.

These new, standalone standards focus on the needs of older patients who live in care homes, and their families – taking into account feedback from practices that are signed up to the original standards about what works and what doesn’t.

Embedding best practice

The aim is to support practices to embed best practice into their day-to-day work; to provide the whole general practice team with a structured opportunity to reflect and build on their own work as they identify lessons learned.

We know GPs and their teams are busy – particularly right now, delivering two mass vaccination programmes, as well as business-as-usual - so we’ve focused on bite-size quality improvement activities, that slot into and enhance their usual activity. Often, it’s the simple steps that can make a big difference to our patients, their families and our teams alike.

I’d like to encourage as many practices as possible to sign up to these new Daffodil Standards and download them from the RCGP website. They are distinct from the original standards supporting the whole practice population. By using this structured approach to plan and provide end of life care, teams are bound to see quickly a positive impact on the experience of older care home residents and their families.

We hope that these new Daffodil Standards will ensure that older people living in care homes are able to have as full a life as possible right up to when they die.

Dr Catherine Millington-Sanders is RCGP and Marie Curie national clinical champion for end of life care

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