End of Life Care Quality Improvement Resources

General practice, alongside primary and community services teams, plays a key role in the delivery of care to people, and those important to them, affected by advanced serious illness and end of life care - a clinical priority area for the RCGP. The College encourages GPs and primary teams to regularly keep up to date on end of life care, depending on their role and relevant learning needs. General practice service development plans should consider how practices continuously improve the provision of end of life care, both directly and in collaboration with the wider system. 

In 2019-2020, end of life care featured as a quality improvement module in the Quality and Outcomes Framework in England. Working in partnership NHS England, RCGP and Marie Curie partnership, Macmillan and the North West Clinical Network have developed a series of multi-professional blended learning resources to support learning and best-practice end of life care quality improvement in your practice. 

These modular education resources are free to access, simple to use and provide useful and meaningful continuous professional development (CPD). The resources can be used over coffee, with colleagues or as part of teaching. They can also be used by, and with, colleagues beyond primary care.

The resources also support the RCGP and Marie Curie Daffodil Standards – the UK General Practice Standards for Advanced Serious Illness and End of Life Care. The Standards have been designed by GPs and experts to offer a structure for practices, whatever the starting level, to have a clear strategy to consistently deliver the best care to all people affected by terminal illness. Further information on RCGP EOLC resources RCGP End of Life Care toolkit and quality improvement tool, RCGP QI Ready. Please make use of these resources as personal CPD, teaching aids as well as to help enable service improvement within your practice.

Learning materials

1. Animation film on how to interpret initial baseline audit (7 minutes)
   
   

2. Multi-professional podcasts

• How to support family and carers in end of life (0.5 CPD points)

•  Developing a compassionate workplace culture and leadership in general practice – learning from a GP pilot site (0.5 CPD points)

3.  Multi-professional short screencasts 

• Practical steps to assessing your baseline and developing a compassionate workplace culture and leadership in general practice (0.5 CPD points, Note: doing a staff survey on EOLC experience and compassion in the workplace, using RCGP template, will earn a further 1 CPD. Reflection on your survey and forming your practice quality improvement plan can earn additional 1-2 CPD points)
  
  

• Communication and listening skills – An introduction, for receptionists, HCAs, administrators etc (10 minutes)
  
  

Educational packages 

• Masterclass 1 - Learning from your retrospective death audit in general practice (0.5 CPD points. Note: doing an audit of your last 20 deaths, using RCGP template, will earn a further 1 CPD. Reflection on your audit and forming your practice quality improvement plan can earn additional 1-2 CPD points)
  
  

• Masterclass 2 - Early identification of patients reaching the end of life (up to 0.5 CPD points)
• Masterclass 3 - Courageous Conversations for GPs: COPD, Metastatic Cancer, Heart Failure and Lung Cancer (up to 1 hour CPD points)
• Masterclass 4 - Personalised care and support planning (up to 1.5 hours points)
• Masterclass 5 - Identifying, assessing and supporting carers (up to 1.5 CPD points). A list of resources relevant to this Masterclass can be accessed here.  
  
  
  
  
  
  
  
  
  
  

We would like to thank NHS England and NHS Improvement for commissioning the development of these resources to help support General Practice improve end of life care. 

Acknowledgements 

• NHS England and Improvement 
• RCGP
• Marie Curie 
• North West Clinical Network
• Macmillan
• Manchester University
• University of Cambridge 
• Sage and Thyme 
• Dr Catherine Millington-Sanders, RCGP and Marie Curie End of Life Care Clinical Champion
• Professor Gunn Grande, Manchester University 
• Dr Gail Ewing, University of Cambridge 
• Dr Elizabeth Phillips, GP Partner, Springfield Surgery 
• Michael Connolly, Manchester University NHS Foundation Trust
• Dr Joanna Bircher, RCGP QI Clinical Champion and Clinical Director of GM GP Excellence Programme 
• Dr Rachael Marchant, RCGP End of Life Care Clinical Support Fellow