GSF developed from ‘the bedside not the boardroom’; refined by clinicians rooted in practice in each setting to ensure programmes are transferable, effective and sustainable in practice.

Origins & Spread of GSF

The Gold Standards Framework and the work of The National GSF Centre in End of Life Care was first developed in England back in 2000 by Prof Keri Thomas, working then as a GP and Palliative Care Doctor in a hospice.

Working with other interested GPs and Palliative Care specialists, they wanted to discuss what ‘a gold standard of care‘ for people nearing the end of life would look like, and then develop a practical step-by-step framework to get there.

The early pilots in 12 GP practices were successful, and strongly affirmed the importance of providing top quality care for people nearing the end of life, serving as a real aspiration for many that sometimes felt unable to achieve.

This was recognised nationally as an example of best practice by the Department of Health, then from 2004 was mainstreamed in NHS policy and grew nationally across the UK, until every GP Practice was using basic level of GSF (Bronze level) by 2010.

The Care Homes programme was developed in 2004, followed by the Hospital programme in 2008 and subsequently grew to 12 GSF programmes across all sectors, each based on the same underlying principles and framework, tailored for each setting.

Timeline

1 1999-2002 Early days

GP in Yorkshire with NHS support and NHS funded pilot (Macmillan part funded)

2 2003- 2010 -NHS

Quality improvement model
GSF mainstreamed to every UK GP practice QOF 2004
KT -DH National Clinical Lead Palliative Care
NHS EOLC Strategy+ Programme - DH funded
3 GSF programmes
GPs care homes , hospitals

3 2010-2020 –GSF Centre CIC

Not-for-profit vol sector CIC Social enterprise from NHS
Self-sufficient ,no fundraised
Grew to 12 programmes in the UK and 18 Regional Training centres

4 2020 onwards

GSF UK continues through The GSF Centre CIC , working in association with Hospice UK and other organisations .
GSF International continues separately for charitable work in Africa through The Andrew Rodger Trust and other non-UK work through Horizon

Within healthcare, there was a gradual shift from a focus on Cancer patients towards the inclusion of a wider range of conditions such as organ failure, frailty, dementia and multi-morbidities. This was greatly enhanced by the recognition of Frailty as a condition and the use of the Electronic Frailty Index.

With the UK's Quality Outcomes Framework (QOF), changes in the GP's Contract in 2004, improving care for all people irrespective of diagnosis was recognised.

The BMA then asked Keri at University of Birmingham to develop the PIG guidance to help GPs identify which patients with non-cancer need to be included on the GSF Registers. This was formerly known as the GSF Prognostic Indicator Guidance but since 2016 known as the Proactive Identification Guidance , and to enable more proactive care for all people nearing the end of life.

For more on the PIG Tool, click here

After 20 years we estimate we have trained over 20,000 staff in over 3,500 teams, and affect the care of at least half a million people every year.

Spread of GSF

Since then GSF has spread across the UK to be used at basic level by every GP practice, thousands of care homes, hospitals and other care providers, affecting the care of many millions of people.

Spread

GSF Training programmes to all settings

12 GSF programmes across all settings of health and social care including; Primary Care GSF (2000), Care Homes (2004), Acute and Community Hospitals (2008), Domiciliary Care (2012), hospices, prisons, retirement villages and other settings with support programmes including Spiritual Care, Dementia care and Clinical Skills. 18 current GSF Regional Training Centres in the UK providing some GSF training

Depth

GSF accreditation

8 Accreditation processes with the GSF Quality Hallmark Awards co-badged by national organisations and recognised by CQC, with some care homes now returning for 4th time accreditation 12 years on.