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International Flags

'In the course of my research I concluded that the UK's GSF is probably the most effective framework for primary, secondary and tertiary integration'

Janet Dunbrack

Independent researcher 

Canadian Hospice and Palliative Care Association

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GSF International Examples

The work of GSF international is to enable people beyond the UK to benefit from GSF Learning, principles, tools and programmes to enable more to care better for people in their last phase of life.

This builds upon the 20 years of work in the UK, plus a wide number of pilots, use, visits and collaborations worldwide in their use and adaptation of GSF.

This includes Australia (Tasmania, Adelaide GSF Care Homes), Canada, Japan, Southern Ireland, New Zealand, Belgium, Portugal, South Africa, Singapore, Holland, China, USA and many others.

Experience of GSF worldwide

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In 2009, we were asked to speak at Victoria Hospital Cape Town  about enabling generalists through GSF to an audience including two doctors, Clint Cupido and Lindi Van der Niekerke. 


This was developed into the Abundant Life Project using many of  the GSF principles. We revisited it a decade later, celebrating its 10th Anniversary. This wonderful work continues to support patients to live as well as possible and receive improved levels of support and palliative care.

See Abundant Life Victoria website here 


Later in 2016, we were invited to work more closely with the large public 1000 bed Groot Schuur Hospital in Cape Town. An initial GSF-led scoping week was undertaken. The development of early identification of patients using the GSF PIG was helpful  (publication of a paper on the benefits of early identification in this hospital) and teaching on advance care planning with the spiritual care and social work teams. 


See the paper and examples here See GSF Africa page here 

Cape Town, South Africa

Abundant Life, Victoria Hospital and Groot Schur Hospital

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Japan and China 

Japan has a 'super aged' population and a team of geriatricians were struggling to find ways to improve end of life care. They were interested to learn more about GSF and had a 3 day visit to the GSF Centre. A TV programme was made about our work, with much publicity in Japan.


Later  Keri was invited in 2016 by Dr Senda Geriatrician,  Department Home Care Promotion, National Center for

Geriatrics and Gerontology, Obu in Japan, to give an introduction of GSF principles of early identification and offering of earlier advance care planning discussions in several hospitals in Japan. 

There have been 2 visits to China by members of the GSF team, to Beijing and Guangzhou, led by Prof KK of Birmingham and Peking University. There was much exchange of ideas and discussions about adaptation of GSF in China.

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GSF in Primary Care



Since 2011 there have been GSF projects in many areas of Australia, adapting some of the GSF principles and tools within Primary Care eg. Geelong Family Doctors Practice, Brisbane, Sydney, Newcastle etc.


We have been working mainly with the Australian Palliative Care Association and GP Associations and Leaders such as Prof Geoff Michell from Brisbane University. 

Vancouver, BC, Canada


Since 2011 there has been much interest in using GSF principles and approach within Family Doctor teams to improve early identification patients, including a register and offering of advance care planning conversations, led by Dr Doris Barwich.

Amsterdam, Netherlands


Since 2013 there has been a detailed project involving GPs in Amsterdam using GSF in Primary Care to develop registers, MDT meetings and offer advance care planning and to embed this within the system.

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An island of best practice 

The small island of Jersey, part of the Channel Islands, has a population of about 100,000 people, with one hospice (Jersey Hospice Care), one hospital, 12 GP practices and a large number of care homes and domiciliary care providers.


Jersey is an independent state, separate from the UK, with much autonomy and central regulation, yet with a dispersed  independent provision of care across the island. They wanted to improve joined-up care for all people who may be in their final years of life.

In 2016 the team at Jersey Hospice decided to introduce GSF to all key providers of end of life care across the island. This was implemented through a 3 year project plan, in which the GSF team led workshops, online training programmes and remote support to a wide number of care providers.


An independent evaluation in 2019 was undertaken and a report made with recommendations for future care. The findings of the report were very encouraging, with whole-island cross-sector improvements, both in outcomes, experience of patients, families and staff as well as in communication, culture and language.

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“Significantly reduced the number of people dying in hospital – 26%. More of a ‘one-system’ support.”

“The whole system has become more robust”

“GSF has changed the culture of care”

“Empowered patients to feel part of their care”

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