Case study:

07 September 2007

Introducing the Gold Standards Framework and Liverpool Care Pathway to health care professionals in Tameside and Glossop PCT

Key points

Most primary healthcare staff in Tameside and Glossop PCT as well as two nursing homes are now using the GSF and LCP in their care of patients in the last six to 12 months of life.

Early figures suggest that as a result there has been a reduction in inappropriate admission to hospital at the end of life with more patients able to make active choices about their end of life care.

There has also been increased prescribing of anticipatory end of life drugs.

Over the last 18 months 39 out of 41 GP practices and all district nursing teams have adopted the GSF and LCP.

Two nursing homes are also using the tools with another two undertaking the programme and Shirehill Hospital, an intermediate care hospital in Glossop, will start using them this autumn, 2007.

The programme, which began in January 2005 and is funded by the Greater Manchester and Cheshire Cancer Network, involved providing education and training sessions on the GSF and LCP to all members of the primary health care teams as well as some nursing homes staff.

All participating GP practices were registered with the GSF central team and were encouraged to develop local documentation and new anticipatory drug authorisation sheets.

A multidisciplinary palliative care working group was also set up with the out of hours service, which includes evening and night district nurses, case managers, GPs, Macmillan nurses and others.

A palliative care respite team supports patients within their own home during crises or at end of life.

This team now has five staff members and is integrated into the district nursing service, providing care and support for cancer and non-cancer patients.

The trust has organised palliative care events and workshops to promote local interest in palliative care provision.

An audit of the LCP reveals more patients are being cared for at home and crisis admissions have been reduced.

There is also increased collaboration between health care professionals with regular meetings to discuss patients.

Meanwhile GPs, out of hours services and District Nurses report greater confidence and job satisfaction in undertaking palliative care.

Future plans include rolling out the GSF/LCP programme to all nursing homes within Tameside and Glossop and providing ongoing support for those already in the programme.

It is also planned to pilot the PPC document within the PCT.

The service wants to encourage health care professionals to recognise that patients with non-malignant life limiting illnesses – for example, respiratory, heart failure and dementia – also require supportive and palliative care.

So, for instance, the trust’s night sitting and support services, currently only available to cancer patients, may be extended to patients with non-malignant disease.