End of Life Care Spotlight Project

Over 500,000 people die in the UK every year – one person every minute. This number is set to grow and, combined with an ageing population living with complex, life-limiting conditions, the number of people who will need palliative and end of life care will continue to increase. We know that more can be done to improve people’s end of life experiences – one in four people don’t get the care and support they need at the end of their life.

General practitioners play a key role in caring for people with advanced serious illness and those who are nearing the end of their life. But providing that care at a consistently high level of quality can often be challenging.

We have partnered with Marie Curie to develop the Daffodil Standards: UK General Practice Core Standards for Advanced Serious Illness and End of Life Care. 

The Daffodil Standards are a blend of quality statements, evidence-based tools, exercises and quality improvement steps. They help practices place continuous learning and quality improvement at the heart of end of life care.

GP practices which voluntarily sign up to the Daffodil Standards make a commitment to undertake a programme of continual improvement. The standards do not replace any existing standards, formal accreditations or training programmes. Developed with a wide range of experts and GP practices, the standards are based on evidence. They outline eight core domains in which GP practices should aim for the highest possible standards to ensure compassionate, safe and effective care. Each area includes free tools to help
achieve step-by-step improvements.

The aims of the project 

The Daffodil Standards are a set of voluntary standards for GPs, to help them assess and improve the end of life care they provide.
Developed over the last two years in consultation with GPs, the standards are self-assessed, and each standard includes support resources. Practices who adopt the standards will be able to display the Daffodil Mark, highlighting their commitment to excellent end of life care, and support for people with advanced serious illness.

The Daffodil Standards cover eight core areas:

  • Early identification
  • Professional and competent staff
  • Early identification
  • Carer support – before and after death
  • Seamless, planned, co-ordinated care
  • Assessment of unique needs of the patient
  • Quality care during the last days of life
  • Care after death
  • General practices being hubs within compassionate communities

Key outputs 

Practices across the UK have already piloted the standards. Their feedback has been invaluable in making sure the standards are effective and achievable for practices.

Other outputs

Palliative Care and End of Life Toolkit

Forthcoming work

The Daffodil Standards will be formally launched in Spring 2019, but you can express an interest in adopting them now by emailing circ@rcgp.org.uk 

Clinical team

Dr Catherine Millington-Sanders

Dr Catherine Millington-Sanders

Catherine is the RCGP and Marie Curie National End of Life Care Clinical Champion. She is a Macmillan GP in Kingston, clinical commissioner and educationalist with seven years’ experience as a specialty doctor in palliative medicine. Catherine has experience as London Co-Clinical Director for End of Life Care (EoLC) Network. She chairs the London EoLC CCG Leads Advisory Group, which acts as a sharing and learning forum for London EoLC commissioning as well as being an expert reference group. Catherine is RCGP South London Faculty Educational Chair.  

Dr Millington-Sanders is co-founder and clinical lead for Difficult Conversations; providing training to NHS and Social Care staff on how to have compassionate conversations with people and their families at the end of their lives. Catherine is passionate about improving care and supporting clinicians, CCGs and organisations to provide patients, family and carers with high-quality holistic care, embedding patient and carer experience at the heart of service design. Catherine supports Compassionate Communities UK; actively implementing the Compassionate City Charter and facilitating the development of compassionate and supportive networks in our communities.

Dr  Rachael MarchantDr Rachael Marchant

Rachael Marchant is the RCGP and Marie Curie Clinical Support Fellow for End of Life Care. She is also a Macmillan GP in Southend on sea and the clinical support fellow for the RCGP/CRUK cancer clinical priority. Rachael is a salaried GP in a busy training practice and is passionate about improving end of life care.   

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