Improving Cancer Care

1. Improving Cancer Care Ramesh Mehay

2. Gold Standards Framework The GSF is a • simple common sensical approach to formalising best standards of care into normal practice.

3. Benefits of GSF • communication within the team • co-ordination of care • raises the focus of carer support • Unified structured approach to care

4. The Stages

5. Identify this group of patients ie using the register • Assess for their main needs, both physical and psychosocial, and that of the carers • Plan ahead for problems, including out of hours (see model for good practice)

6. GSF – C1 Practices maintain a Supportive Careregister to record, plan and monitor patient care, and as a tool to discuss regularly at their monthly PHCT meetings. The aims of the meetings are to improve: • the flow of information • advanced planning /pro-active care and • measurement and audit, to clarify areas for improvement in future • at patient, practice, PCT and Network level

7. GSF – C2 Each PHCT has a nominated co-ordinator for palliative care (e.g District nurse/manager/practice nurse) to ensure good organisation and co-ordination of care in the practice by overseeing the process, i.e. • a) maintaining the register, care plans, symptom sheets ,handover forms, audit data, etc. • b) organising PHCT meetings for discussion, planning, case analysis, education, etc. • c) using checklists, tools and protocols to cover all areas of care. eg PACA scale, PEPSI COLA, end-of-life care etc

8. GSF – C3 Control of Symptoms

9. GSF – C4 • Continuity of Care (OOH)

10. GSF – C5 • Continued Learning

11. GSF – C6 • Carer Support

12. GSF – C7 • Care of the Dying Phase

13. Group 1 • Registers : • All cancer patients • Identifying dying patients • DS1500 recording

14. Group 2 • Communication tools – patient held records, home packs, drug cards • PHCT meetings • Networking with the wider team • Recording preferred place of death • Avoiding duplication

15. Group 3 • Control of Symptoms: • EMIS template • Medical, psycho, social, spiritual, religious • Rating scales

16. Group 4 • OOH • Crisis Contacts • (Education – of ourselves, audit, books & resources) • Carer support

17. Group 5 • Care of the dying: • A protocol • A PACE like template for each record