Introduction


 


RCGP Marie Curie Daffodil Standards logo


One person dies every minute in the UK every year, most of whom have an advanced serious illness. The RCGP & Marie Curie national 2015 survey showed that 97% of GPs felt that general practice plays a key role in the delivery of care to people approaching the end of life, and their families. Therefore, being clear as a practice, about your strategy to consistently offer the best care for people affected by Advanced Serious Illness and End of Life Care and the continuous improvement you are looking to achieve is really important.

The Daffodil Standards are the UK General Practice Standards for Advanced Serious Illness and End of Life Care. They are a blend of quality statements, evidence-based tools, reflective learning exercises and quality improvement steps. The Standards are relevant to all UK practices, offering a structure to enable practices, whatever the starting level, to be proactive organisations in which continuous learning and improvement steps are an integral part of caring for people.

By signing up to the Daffodil Standards, your practice has taken an important step towards improving end of life care. Practices can register now to receive a welcome pack. Your Daffodil Standards welcome pack will include notebooks, pens, posters and leaflets for you and your team, as well as the Daffodil Mark, which can be displayed to highlight the practice's commitment to excellent end of life care and support for people with advanced serious illness.

Who designed them?

The RCGP designed the Standards in partnership with Marie Curie, led by Dr Catherine Millington-Sanders, RCGP & Marie Curie National End of Life Care Clinical Champion. Experienced GPs and healthcare professionals supported the process, and helped make sure the Standards fit into the work you’re already doing, rather than adding to your workload.

How will they support my work?

 The Daffodil Standards will empower your practice team to assess and improve the end of life care you provide in manageable, practical ways which suit your practice.You know your patients best, and the Daffodil Standards will help you to quickly create a clear, structured approach that’s relevant to your practice, your staff and your patients.

Do I have to pay to sign up?

No. Access to the Daffodil Standards is completely free.

What do they cover?

The Standards cover eight core areas, with tools, resources and simple steps to help you assess and build on the good care you already give your patients and their loved ones. The eight areas are:

  1. Professional and competent staff
  2. Early identification
  3. Carer Support – before and after death
  4. Seamless, planned, coordinated care
  5. Assessment of unique needs of the patient
  6. Quality care during the last days of life
  7. Care after death
  8. General Practice as hubs within compassionate communities

How long do they take to complete?

The Daffodil Standards are designed to be completed at your own pace. The first step is to start with an audit of your last 10-20 deaths and select which Standards (See Appendix A + B) have room for improvement and follow the simple steps in the flow diagram below to create a relevant and feasible improvement plan, over a set time period. Whether you select one or several Standards to do over the year, the most important thing is to start somewhere - each improvement step counts. Quality improvement does not have to be difficult - small steps and changes can result in significant improvements.

 

How to start: Steps to complete Standards Fig 1 with notes

 

Appendix A - Example Audit Template for the Daffodil Standards and QOF (Word)

Appendix B - Example Audit Template for the Daffodil Standards and QOF (Excel)

Appendix C - Example Daffodil Standards QI PLAN collection template

Link to Self-Assessment Evidence + Guidance

Link to Reflection Exercises

Link to QI guidance 


The Daffodil Standards combine reflective learning to enable quality improvement

1. Understanding and sharing individual experiences to enable practice learning

General Practice is full of everyday opportunities for us to learn from. We can use these to kick-start our reflection on learning as individuals and as a practice. The structured reflective exercises, use the principles of Kolb's learning cycle (figure 2), to support real-time improvement in practice.

RCGP Daffodil Standards Introduction Kolbs learning cycle

Fig 2. Kolb's learning cycle

2. Framing service improvement discussions

The Daffodil Standards are not meant to be 'perfectionistic', instead they allow all staff to start and improve at their own individual pace and for a practice to build on as a journey. The aim is to support a practice to always be ready to ask questions, find new solutions and continue to make small steps – testing change, removing problems/ inefficiencies and refining practice.

The RCGP guide "Quality improvement for General Practice" introduces 4 steps when considering the area to be improved with helpful tools for implementing each step

3 RCGPDaffodil StandardsIntroductionQI cycle

 

Step 1: Diagnose – assess the area that requires improvement and generate some baseline data
Step 2: Plan and test – decide the aims, methods and monitoring of your change. Test your intervention in a graded fashion
Step 3: Implement and embed – make any successes part of your systems or processes.
Step 4: Sustain and spread – consider how your aims or intervention can continue to be implemented on a larger scale.

Brief details of some of these tools that you could use can be found in the QI guidance section of this document. Full details can be found in the RCGP Quality Improvement for General Practice guide.

The Daffodil Standards: Self-Assessment Evidence and Guidance >

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