" GSF opened up a whole new way of looking at end of life care for us and helped make sense of the journey. The result is that we can now help people have a better life now and a more personalised death.”
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Team Leader GSF Accredited Hospital Dorset
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The GSF Hospitals Training Programme
The Gold Standards Framework Hospitals Training and Accreditation programme has been used in the UK since 2008 by over 100 acute and community hospitals, with 12 whole hospital projects covering all wards, and dozens of wards GSF accredited and reaccredited 3 years on with the Quality Hallmark Awards.
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This very successful, evidence-based GSF Hospital Programme in End of Life Care is built on the use of GSF in the community since 2000, and now is a key part of the use by Integrated Care Systems as Cross Boundary Care sites involving GSF in all sectors.
Improving End of Life Care in hospitals is recognised as being crucial to enhancing care for the wider population. With earlier identification of patients in their last year of life and more advance care planning, there can be better quality of care for patients, fewer hospital deaths, re-admissions and a reduction in hospital bed days, with fewer crisis admissions and more enabled to die at home.
GSF Hospitals in a Nutshell
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GSF in Hospitals- example of excellence from Southport and Ormskirk , UK
The hospital death rate in the UK has fallen over recent years and is now under 50% of all deaths. Also evidence confirms that about 30% of hospital patients are in the final year of life ( See here Clarke 2014 Imminence of Death ), so earlier identification can lead to better planned proactive care in the final years of life.
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Recognition by the regulator CQC
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GSF is seen in the UK as a marker of excellence, a means of putting national policy into practice (eg NICE Guidance in EOLC and UK National policies in End of Life Care).
GSF is recognised by the regulator (in England the Care Quality Commission-CQC) – GSF is the only CQC-approved End of Life care Accreditation scheme in acute or community hospitals in England.
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"GSF has helped us be much better at identifying significant changes in patients’ condition and then explaining this to families.
We are now able to walk alongside them on the journey"
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Ward Manager GSF Accredited Hospital Dorset .
What is involved in the GSF Hospitals training?
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The GSF-I Hospitals Programme reflects the work of GSF -UK hospitals programme , but would be adapted to each setting, requirement and culture. It includes:
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Training films and workshops –structured interactive workshops sharing good practice and step-by-step progress to support implementation in practice.
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Tools and resources – All resources required including teaching materials, posters, films, leaflets, ward folders, Good Practice guides etc.
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Measures – Intrinsic evaluations showing progression with evaluations at the organisational, patient and staff level and are aligned with national targets
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Support – discussions on tailoring GSF to local needs and context, and individualised coaching sessions between workshops as require.
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Hospital Accreditation has been developed in the UK and is possible for international programmes with modifications - to be discussed if interested . It is important to align with national policies and standards so to tailor for each country
Dr Linda Wilson describes progress of GSF in Airedale Hospital, Yorkshire and the value of the Gold Line for Gold patients
Dr Karen Groves describes how GSF was introduced in 2010 to Southport Hospital and the impact it has made in improving end of life care for all.
Example from Dorset Community Hospital
Experience of GSF in UK hospitals
"I think the biggest change has been the culture change... it’s about getting patients and their families to take ownership of their care. GSF is the framework that allows us to make that happen.
The best bit is making sure that patients receive the care they want, where they want it, when and how they want it and the satisfaction they and we get from that."
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Dr Kumar, Stroke Consultant
Royal Lancaster Infirmary
"GSF has helped bring the team together in a way none of us had expected. Everyone, including the domestic staff feel engaged and have come up with brilliant ideas for how we can deliver even better care."
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Dr Elisabeth Bjorndal, Palliative Care Consultant
Margaret Centre at Whipps Cross Hospital.
“Implementation of GSF is encouraging a systematic approach to recognising those patients in hospital who might be in their last year of life, leading to more proactive care and opportunities for people to consider and express their wishes and preferences.”
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Dr Clare Marlow, Consultant Palliative Medicine
Wolverhampton Hospital
"I’m really proud of both our teams for achieving this. It’s been a lot of hard work, especially when they have a lot of competing priorities.
The most important thing about identifying patients who are nearing the end of their lives is that it gives them more choice and control over their own care."
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Heather Wright, Palliative Care team leader
Barking Havering and Redbridge
Experience of GSF in non-UK hospitals
South Africa
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An initial GSF-led scoping week was undertaken in a large 1000 bed hospital in Cape Town in 2016.The development of early identification of patients using the GSF PIG was a great start in enabling more people receive improved proactive care, and there was further teaching in advance care planning with the spiritual care and social work teams.
Also some GSF principles were used in the Abundant Life Project from 2009, which continues to support patients to live as well as possible, and receive improved levels of support and palliative care
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South Africa Groot Schur Hospital and Abundant Life Project
Victoria Hospital
Further Reading
Japan
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An in Introduction of GSF principles of early identification and offering of earlier advance care planning discussions were helpful in several hospitals in Japan.
The work was led by Dr Senda Geriatrician Department Home Care Promotion, National Center for Geriatrics and Gerontology, Obu, Japan and followed a visit by Prof Keri Thomas in 2016
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GSF Frontrunners in Hospitals - See case studies and examples from GSF Accredited hospital wards demonstrating what is possible to achieve and the considerable progress made. To view, click here
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GSF- UK Hospital Training Information Flyer - from the GSF Centre based in the UK for GSF-UK work in hospitals. A similar programme is available for GSF International with remote teaching and on-line films. To view, click here
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Poster Summary of Hospital Programme - a useful summary poster used at EAPC Conferences, describing the aims, methods, outcomes and impact of the GSF Hospitals Programme. To view, click here
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