Improving Cancer Care Ramesh Mehay

Gold Standards Framework The GSF is a simple common sensical approach to formalising best standards of care into normal practice.

Benefits of GSF communication within the team co-ordination of care raises the focus of carer support Unified structured approach to care

The Stages

Identify this group of patients ie using the register Assess for their main needs, both physical and psychosocial, and that of the carers Plan ahead for problems, including out of hours (see model for good practice)

GSF – C1 Practices maintain a Supportive Care register to record, plan and monitor patient care, and as a tool to discuss regularly at their monthly PHCT meetings. The aims of the meetings are to improve: the flow of information advanced planning /pro-active care and measurement and audit, to clarify areas for improvement in future at patient, practice, PCT and Network level

GSF – C2 Each PHCT has a nominated co-ordinator for palliative care (e.g District nurse/manager/practice nurse) to ensure good organisation and co-ordination of care in the practice by overseeing the process, i.e. a) maintaining the register, care plans, symptom sheets ,handover forms, audit data, etc. b) organising PHCT meetings for discussion, planning, case analysis, education, etc. c) using checklists, tools and protocols to cover all areas of care. eg PACA scale, PEPSI COLA, end-of-life care etc

GSF – C3 Control of Symptoms

GSF – C4 Continuity of Care (OOH)

GSF – C5 Continued Learning

GSF – C6 Carer Support

GSF – C7 Care of the Dying Phase

Group 1 Registers : All cancer patients Identifying dying patients DS1500 recording

Group 2 Communication tools – patient held records, home packs, drug cards PHCT meetings Networking with the wider team Recording preferred place of death Avoiding duplication

Group 3 Control of Symptoms: EMIS template Medical, psycho, social, spiritual, religious Rating scales

Group 4 OOH Crisis Contacts (Education – of ourselves, audit, books & resources) Carer support

Group 5 Care of the dying: A protocol A PACE like template for each record