Standard 1: Professional and competent staff - Example GP Practice Team EOLC group exercise

Record: Those attended, apologies, and date of meeting

The aim

  • To enable clear leadership and a culture of learning and quality improvement within the practice
  • For each staff member to tap into their own experiences of handling patients and carers affected by advanced serious illness and end of life care.


  1. Select a patient where learning can be achieved
  2. "No blame" culture
  3. Encourage reflection
  4. Make recommendations for improvement
  5. Re-assess actions or learning at a later stage


Using a significant event analysis format where the culture of the practice is conducive to reflection has been shown to be effective in providing support and learning to the practice team.


  1. Consider the leadership model the practice wants to develop to enable high quality care for people affected by advanced serious illness and end of life.
  • Who is best placed (for example, skills, time, desire) to be the clinical and administration lead for the Daffodil Standards?
  • How will the practice support them? Time, training, coaching, development support to staff etc
  • How much quality improvement experience had they got? How can they ensure they have minimum baseline knowledge? For example, modular learning: West of England Academic Health Science Network Education Pathway. Is there a GP network available to share practice learning?
  • How will they know they are making a difference/ improvement?
  1. Each person to think about a specific patient or carer you have handled who was/is affected by advanced serious illness and/or end of life needs.
  • Go round the group and ask people to say which patient they are thinking of. Agree a patient to discuss.
  • Consider tasks undertaken by members of the team when caring for people affected end of life
  • Ask people to volunteer A FEW WORDS ONLY what was most rewarding about being involved in their care.
  • Discuss the following questions as a group (and someone take notes on the key points):
  1. What happened with the patient initially?
  2. What happened with the patient initially?
  3. What happened subsequently?
  4. How did the person present to or get noticed by you?
  5. Who else in the practice knew them?
  6. What were their potential needs – health, psychosocial, spiritual, practical and other? Explore different people's attitudes, beliefs and experiences
  7. What worked well /made a difference? – for the patient, for you, other staff, for the practice?
  8. What was the learning for you?
  9. Was there learning for the practice an external to the practice
  10. What will you do differently in the future?
  11. How and when will you address learning for you, the practice, and external to the practice?
  12. Set a review date.

Informing part of the evidence on Standard 1

  • Helps identify those involved in AOI and EOLC
  • May identify roles
  • Can identify learning needs
  • Case history recorded
  • May involve patient/carer
  • Demonstrates sensitive communication
  • Can form part of SWOT analysis

Next: Standard 2: Early identification >

QI 1: Continuous Improvement

Yearly SWOT (strengths, weaknesses, opportunities, and threats) analysis of the practice's ability to provide high quality, safe and compassionate care for people affected by Advanced Serious Illness, and End of Life Care.

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