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" We have more confidence in caring for patients, more  awareness of their needs, better planning and preparation, so that patients have a better death and families can grieve better."

 


DR VM York GP

GSF Accredited Practice 

GSF- Impact

Impact of GSF nationally 

 Every year GSF helps:

  • GSF improves the care for about 500,000 people/year

  • Trains over 500 health and social care teams

  • In about 40 areas of the country

  • With up to 200 teams accredited with the GSF                                      Quality Hallmark Award

Overall, since 2010, The GSF Centre UK has trained:

  • GSF Facilitators in every PCT/CCG with 98% GP practices            in the UK doing foundation of Bronze GSF since 2004

  • 631 GP Practices doing Gold/Silver GSF training 

  • 49 Acute Hospitals, 303 wards

  • 50 Community Hospitals, 62 wards

  • Almost 4,000 Care Homes

  • Over 2000 Domiciliary Care workers

  • 29 Retirement Villages

  • 8 Hospices

  • 3 Prisons

  • With 10 Cross Boundary Care Sites using GSF across sectors

  • Over 800 teams have been accredited, with over 100 now                   4th time accredited 15 years on.  

  • Affecting the care of many millions of people in the UK

Impact 

Over the years , GSF has trained many thousands of frontline teams,    and  improved the care                    for many millions of people in the UK  

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GSF Evaluation is intrinsic in all programmes, including measures

of progress as well as impact assessment.

The impact could be said to be at both ‘hard’ and ‘soft’ levels,

both of which are important in terms of outcomes, processes and

the confidence and competence of staff, enabling people to

receive a better experience of care at the end of their lives.

Hard measures

  • Spread and integration

  • Proactive - Increased early identification on registers and proactive care (non-Cancer, frailty, care homes residents)

  • Personalised - Increased advance care planning,

  • Coordinated - joined up

  • Decreased hospitalisation crises, hospital admissions + deaths, more dying where choose.

What does GSF improve?

Proactive Care

  • Earlier identification of people in final years of life with any condition, any setting

  • More needs-based proactive planning by teams- GSF as a common vocabulary

  • Supporting families and carers, reducing crises, earlier support offered

Person-centred care

  • More offered Advance Care Planning discussions​

  • More goal-concordant care; wishes and choices noted and attained

  • Improved experience of care, aligned to preferences

Better coordinated integrated care

  • Improving teamwork + communication- everyone's involved in end of life care

  • Improving outcomes- reducing hospital crises and deaths, more living and dying where they choose

  • Improving integrated cross boundary care and cost effectiveness- whole system change

GSF Evaluations

Baseline + follow up measures to help assess current activity and support improvements.

Audits

  • Key outcomes measures

  • ADA

  • Organisational questionnaire

  • Staff confidence

 

Trackers tool - progress

  • Run charts

  • Numbers identified

  • Numbers offered ACP

  • Hospital Admissions

Impact Assessment

  • Quantitative

  • Qualitative

Accreditation data for evidence summaries and Frontrunners

Soft measures

  • Changed culture

  • Empowered staff – broadened focus

  • Improved teamwork 

  • Improved staff confidence

  • Improved patient satisfaction

  • Improved continuity, communication

  • Springboard for other developments – Gold  patients, Gold Line support , e-registers etc 

  • Helpful during COVID

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Findings from GSF Accredited teams across all areas.

Increasing numbers come for Accreditation and Re-accreditation every 3 years with many care homes now GSF Accredited for the 4th time, 14-15 years since initial training.

Re-accredited practices show GSF is sustainable long term once embedded.

 

Cumulatively, we assess progress of GSF Accredited teams, demonstrating a growing trend to whole system

improvements in care.

To see GSF Accredited teams' progress and achievements in the GSF Front Runner Papers in Evidence section click here

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To see GSF Accredited teams' progress and achievements in the GSF Front Runner Papers in Evidence section click here

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"The GSF training has helped us change the culture of the practice"

"Since completing the GSF training, we have more than halved the number of days identified patients spent in hospital

ACP offered 

Average 68%

“GSF has helped to take us to a new place”

 

Dorset GP

Identification

Average 65%

Population-based integrated care.

GSF has been used in wider geographic areas and Integrated Care Systems, and  have become a common vocabulary across all settings.

Several areas use GSF in multiple settings as part of the Cross Boundary care including Dorset, Nottinghamshire, Wolverhampton, Doncaster, Morecambe Bay, Barking, Havering & Redbridge, Southport, Airedale. NE Essex,  and the whole island of Jersey!

Many built on the concept of early identification of  prioritised 'Gold' or GSF patients . See more about Integrated Cross Boundary Care Sites here

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Jersey: Example of whole island culture change

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What does GSF Provide?

We teach

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Listening and Scoping. The first step in adapting GSF to any location or country is deep listening- scoping the needs, aims, capacity, resources and other requirements, involving interactive workshops, feedback, external stakeholder views and objective reports where available, to include or help focus the adapted GSF training required. 

 

Adapting. The basic GSF framework stays the same for different settings  (built upon the 1-3-5-7 model), tailored and adapted to local needs  according to the above scoping process .

Teaching. The work at GSF, both GSF-UK and GSF-International, then involves delivering  GSF training programmes via online training and videos, and workshops with groups of generalist care provider looking after people in their final years.   

Using experiences of others . GSF adapted programmes include teams in care homes, prisons, homecare agencies, retirement villages as well as GPs and hospitals, from porters and care assistants to consultant cardiologists and general practice teams, family, friends and carers - everyone’s involved!

We provide tools, resources & guidance

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We developed various practical tried and tested tools including guidance that is widely used to help recognise decline earlier, to ensure more people received earlier more proactive care in line with their wishes. 

We support

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We support local trainers and facilitators in a train the trainers model enabling a cascade of implementation, much wider and deeper than we could do alone.

 

We coach, enable and support local facilitators or GSF leads plus  the wider network through Communities of Practice and frontrunners .

 

We encourage adaptation and localisation where appropriate , tailoring to local culture, context, needs and resources and can help develop local Accreditation.

We measure

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We have a large suite of evaluation metrics for all areas enabling assessment of progress (based on Quality Improvement teaching) and for attainment of standards and assessment of progress . These can later contribute to GSF Accreditation Awards. 

 

Further metrics are used for assessments of individual patients, teams (Key Outcomes ratios etc), wider communities (the GSF EOLC CCG metrics) and have contributed to the development of national policy guidance such as NICE Guidance in End of Life care and provision of EOLC services.

We celebrate!

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How is GSF training delivered ?

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Each GSF Programme includes;

Promotional materials  

  • Flyers, information sheets

  • Nutshell videos on webpages

  • Bronze​, Silver  and Gold options 

Training materials

  • Good Practice Guide, workbooks

  • Workshops, PowerPoints,

  • GSF animated summary video & examples of practice 

 

On-line training programmes

  • through Virtual Learning Zone

  • With matching interactive virtual workshops

 

Tools and resources

  • all resources needed including PIG, needs-based coding and support matrices ,ACP guidance, tools video 5 Steps to ACP and more on Members area of website

Measures - Evaluation metrics

  • After Death Analysis/ Supportive Care Analysis , Key outcomes ratios, Organisational and staff  confidence  questionnaires, QI run charts

Support

  • Ongoing support and coaching of to local facilitators 

  • Train the trainers 

  • Community of practice and frontrunner examplars 

Accreditation process (UK based if wanted ) 

  • Comparative evaluations, Portfolio, Visit, Panel with independent co-badging organisation

  • Quality Hallmark Award at conference 

  • or guidance to develop your own accreditation process 

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GSF Training Plan – Workshop Sessions / Webinars

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To Register for GSF  International Training Programmes

 

The GSF programmes in each setting included here were  mainly developed and used within the UK in the last 20 years. Most GSF principles, tools and training are simply transferable, with some adaptations and tailoring to fit the needs of each nation's culture, experience and resources. Its usually helpful to have  a time of listening and scoping before adaptation and piloting in your country, to best meet local  context, needs and requirements . 

If you wish to register for GSF training, please

  • contact us to book a discussion by zoom,

  • complete a registration form

  • confirm scoping and listening plans

  • confirm numbers, location, timing and facilitation plans

  • confirm funding, evaluations and other requirements . 

Once registered and confirmed,  you will ​receive access to the online GSF training programme via the Virtual Learning Zone,  all required resources with detailed guidance, tools and evaluations via the Members area and planned support  with  interactive workshops by Zoom .

 

Most GSF training is delivered as a cascade via a locally  facilitated train-the trainer model, so training and support for your facilitator is vital. You will then become part of a  global community of practice, sharing examples and experience with others across the world.

Charges for GSF training vary according to various factors. Any profit from international work in developed countries goes towards the work of GSF Africa through the Andrew Rodger Trust charity.

For any other queries, please feel free to contact us

 

Further Reading

To read the 'Overview of the work of the National Gold Standards Framework Centre'  including details of GSF training programmes and impact in the UK click here

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