Quality palliative care can and must be delivered by generalists in hospitals, at home and in nursing homes to reach everyone. With training and innovative support from specialists, even complex chronic disease management can be provided in the community. Co-ordination and sharing of electronic patient records can facilitate this.
Choosing where to die
In many economically developed countries only about 20 to 25% of people die at home. However, it is believed that over 50% would prefer to die at home if possible.
See (EJPC - Hockley) for an overview of issues relating to supportive and palliative care in different care settings.
The Gold Standards Framework
In the last decade Professor Keri Thomas has pioneered in the UK the development of the Gold Standards Framework of Care, which at present is used in over 80% of UK primary care teams. It gives a framework for general practitioners and community nurses to organise and co-ordinate care within their practices. In the UK all patients in primary care are registered with a specific practice, so lists of all patients are available, and this framework is based on creating a register of all patients identified for supportive or palliative care within each practice.(1)
The three main steps of the Gold Standards Framework approach are
- Identify which patients would benefit from more support
- Assess their current and future clinical and personal needs
- Plan their future care
Establishing a Care Home Centre of excellence, innovation, training and research
Improving palliative care in care homes
Caring with Integrity
- The gold standards framework. The essentials of GSF http://www.goldstandardsframework.org.uk/About_GSF/TheEssentialsofGSF
- Murray SA, Boyd K, Hockley J, Sheikh A. EJPC 2008;15(6):272-275