End of life and palliative care toolkit

Site: Royal College of General Practitioners - Online Learning Environment
Course: Clinical toolkits
Book: End of life and palliative care toolkit
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Date: Sunday, 23 June 2024, 11:13 PM

Description

Toolkit for healthcare professionals to support patients nearing the end of life to live well until they die.

Approximately 1% of the UK’s population die each year, and within that population the majority of deaths can be predicted. Evidence has found that early identification of patients who are likely to die within the next 12 months often enables well coordinated, pro-active quality care, and allows healthcare professionals to focus on better meeting patients’ needs. It has been developed in partnership with Marie Curie and the Clinical Innovation and Research Centre.

The End of Life and Palliative Care Toolkit provides a collection of tools, knowledge, and current guidance for healthcare professionals to support patients nearing the end of life to live well until they die. The resources include information for patients and those close to them.

Who is the End of Life and Palliative Care Toolkit for?

Any general practice in the UK can use the toolkit. The resources are for healthcare professionals, informal carers, patients and those close to them.

For resources related to end of life care and COVID-19, visit the dedicated section on our COVID-19 Resource Hub.

The toolkit will be updated on a regular basis. Please send any comments or suggestions to daffodilstandards@rcgp.org.uk

What is the RCGP and Marie Curie Daffodil Standards?

The Daffodil Standards are a blend of quality statements, evidence-based tools, reflective learning exercises and quality improvement steps.

The Standards offer a structure, enabling practices to be proactive organisations in which continuous learning and quality improvement steps are an integral part of caring for people affected by Advanced Serious Illness and End of Life Care.

The Daffodil Standards can be accessed for free at: www.rcgp.org.uk/daffodilstandards

By signing up to the Daffodil Standards, your practice has taken an important step towards improving end of life care. Practices can register now to receive a welcome pack. Your Daffodil Standards welcome pack will include notebooks, pens, posters and leaflets for you and your team, as well as the Daffodil Mark, which can be displayed to highlight the practice's commitment to excellent end of life care and support for people with advanced serious illness.

As a patient nears the end of life, a holistic approach is recommended. This approach involves early identification of those likely to be in the last few months of life, discussion of end of life issues with patients and those close to them and provision of high quality care. The process continues after death with support for those left behind as well as reflective practice and audit for the practice team.

In this section:

Current policy best practice

The following resources may be used to determine if a patient is nearing the end of life, and give recommendations of how treatment should be tailored to their specific requirements.

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Clinical treatment guidance

The following resources provide best practice guidance for clinical treatment of a patient nearing the end of life.

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Communicating with patients and those close to them

Current legislation promotes frequent detailed communication between healthcare professionals and patients, their families and others. These tools may be used to communicate with your patients and their support network.

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Current knowledge sources

Legislation and knowledge relating to end of life processes is often changing. The following resources provide ongoing forums and updates in which healthcare professionals may keep abreast of current knowledge.

Quality Improvement

To access shared learning networks to assist you in applying practical QI methodologies to better treat this clinical area, join our QI Ready platform.

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A range of bereavement resources aimed to help general practice provide information and signposting to bereaved patients and families.

In partnership with Marie Curie:

Supporting your patient through loss (animation): overview guide for practices on tips to strengthen bereavement support. These include supporting bereaved people to ask for help from the practice if they need additional support, giving a compassionate bereavement response, signposting to support information and services and using consistent coding to help trigger potential condolence contact and sharing information on how to reach support in the community.

The Grief Support Guide provides information on the variety of bereavement support that is available in the UK, from self-help resources and helplines to peer support groups and grief counselling. The Guide also includes details of support for specific groups of bereaved people, e.g., widow(er)s, children, cultural and faith groups and people bereaved by particular types of death.

The free guide can be downloaded at: www.nationalbereavementalliance.org.uk/support

In partnership with Cruse Bereavement Support:

Sign up for free to the Daffodil Standards 

To assess how well your practice is supporting bereaved people and to make the most of using the above bereavement resources, read more about Daffodil Standard 7 - Care after Death.

Patient resources: Planning ahead

These resources may be shared with patients who have been diagnosed as likely to die within the next 12 months. They provide information for the patient to plan ahead and decide on their care pathway.

Resources for those close to a dying patient

The following resources are appropriate to share with informal carers and those close to a patient who is dying. These resources aim to support individuals affected by the end of life process happening to those close to them.

Resources and guidance for patients and carers

Clinical resources and guidance for practices

With the demise of the Liverpool Care Pathway, there has been much activity and collaborative working between groups involved with end of life care. Current national reports and legal guidelines for healthcare professionals to follow when caring for a person nearing end of life are found in this section.

Training resources to help fulfil CPD and revalidation requirements.

Further study and learning modules for practitioners

As well as reflective practice within local palliative care meetings, such as a practice Gold Standards Framework (GSF) meeting, clinicians are also able to access study days, online learning modules and post-graduate qualifications.

Autism Spectrum Conditions: end of life care and accessing healthcare services

A YouTube guide for clinicians made in partnership with Marie Curie.

Audit

Clinicians and practices may carry out their own audits as part of the GSF meetings and to fulfil their Care Quality Commission obligations. Online tools are also available to help meet this requirement.

Following the phasing out of the Liverpool Care Pathway (LCP) in 2014, new guidance for approaching a dying person was issued by the Leadership Alliance for the Care of Dying People. The current guidelines make the dying person the focus of care in the last few days and hours of life and exemplify the high-level outcomes that must be delivered for every dying person. The way in which care varies is relative to the holistic needs of the individual, and the setting in which they are being cared for.

Developed in partnership with the Clinical Innovation and Research Centre, the guidance and resources within the End of Life and Palliative Care toolkit reflect current guidelines, and provide a toolkit that general practitioners may refer to when working with a patient who is nearing the end of their life.