New standards for end of life care

  • Date: 27 February 2019

A NEW set of standards in providing end of life care has been agreed for GP practices.

The Royal College of GPs has joined forces with charity Marie Curie to create the Daffodil Standards, designed to support primary care teams in caring for patients living with an advanced, serious illness, or at the end of their lives, and their loved ones.

Practices who adopt the eight standards commit to making improvements in at least three of the eight core aspects of care each year, with the aim of having reviewed all of them within three years. Those practices will also be able to display a "daffodil mark" to show their commitment.

The Daffodil Standards are:

  1. Professional and competent staff
  2. Early identification of patients and carers
  3. Carer support - before and after death
  4. Seamless, planned, co-ordinated care
  5. Assessment of unique needs of the patient
  6. Quality care during the last days of life
  7. Care after death
  8. General practices being hubs within compassionate communities.

A survey carried out to coincide with the launch found that 92 per cent of GPs agreed it is important for them to spend time caring for terminally ill or dying patients, and another 87 per cent said that caring for terminally ill or dying patients is a rewarding part of their job.

However, it also revealed an overwhelming majority of GPs (85 per cent) felt they did not have as much time as they would like to care for patients at the end of their life because of their workload. Sixty-two per cent said there were not enough community resources to give families and carers of terminally ill or dying patients the emotional support that they need.

Similarly, 71 per cent of respondents said more resources were needed to help GPs and practice staff to cope with the grief of losing patients. Only two per cent said their practice held formal support sessions on dealing with grief and loss.

Dr Catherine Millington-Sanders, end of life care lead at RCGP and Marie Curie, said: “Our colleagues are already working hard to provide this level of care, but pressures on our system and a lack of resources in the community can sometimes make going the extra mile that bit harder, which can be incredibly frustrating for us and our teams.

“That’s why the RCGP and Marie Curie have developed these standards. Most importantly, they are there to ensure that when patients see the ‘daffodil mark’ in our window or on the wall in our waiting rooms, they know we are committed to providing the care and support they need and deserve.”

RCGP chair Professor Helen Stokes-Lampard welcomed the standards. She said: “Making sure that patients and their families feel supported at the end of life is an essential part of what we do, and in many ways, one of the most privileged aspects of our role.” But she called for more funding to help GPs deal with rising demand.

The standards, which have already been recognised by the new Quality and Outcomes Framework (QOF) on end of life care and the CQC, have been piloted by a number of surgeries across the UK. Each standard comes with its own evidence-based tools, exercises and quality improvement steps.

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