Standard 8: General practice being hubs within Compassionate Communities

The General Practice commits to:

To meet this standard the practice commits to: 

Self-Assessment 

 Practice Guidance

 

8.1 Support the development of compassionate communities

8.1a Develop the practice itself as a compassionate community

  • Discussion in practice meeting what would be expected within a practice to actively support practice team (clinical and non-clinical) in personal death, crisis, loss.
  • Practice plan documented for supporting staff in loss.
  • Plan annually reviewed.
  • Staff survey.
  • Consider current compassionate culture within the practice and how important it is to the practice and how/why this may be improved.
  • Consider how different experiences of staff in personal death, crisis, loss.
  • Consider how staff feel valued by the practice.
  • Consider a clear open mechanism for both staff and patient/ carer feedback, actively and sensitively encouraging participation.
  • Consider how the practice shows compassion to staff and other colleagues, affected by a bereavement of serious illness.

8.1b Learn lessons from patients and their carers
  • System is in place to actively debrief staff and wider team on deaths, particularly where death is unexpected or goes wrong:
  • This could be as part of discussion of deaths at practice meeting or MDT.
  • Survey of patients and/or bereaved relatives and carers.
  • SEA recorded and shared when one has occurred.
  • Respond to any compliments or complaints and share lessons learned.
  • Evidence a system is in place to record and track actions of incidents/ compliments/ complaints/ feedback in order to understand and learn from the care and experience of people who died within the practice over the year for example, against SWOT analysis.
  • Patient / carer with lived experience sensitively invited to be on an active PPG.
  • Consider how the practice delivers compassionate care to patients, families and carers.
  • Consider how to involve your PPG / PPI groups
  • Consider the practice system in place to actively debrief staff and wider team where death is unexpected or does not go to plan AND also where things go right/ well.
  • Recognise patients who died without capacity and without documented wishes for care (ADRT, LPA for H&W) – identify when and where discussions on advanced care planning could have been instigated and share these so that opportunities aren't missed with patients facing similar circumstances.' Alongside, this consideration of whether the person and family's EOL wishes were followed and whether any learning points around working in partnership, or conflict resolution, were identified.
  • Consider how the practice engages with hospices, hospital specialist care teams, community service development in providing care to people affected by ASI and EOLC.
  • GP practice networks may consider holding Schwartz rounds to support colleagues.

8.1c Utilise wider community resources
  • Has information on the benefits of primary care practice models for social prescribing.
  • Has information showing how to access to community support groups to combat issues such as, isolation and loneliness.
  • Refers to community support groups.
  • Practice system in place outside consultations, to actively support people affected by life- limiting illness, death and dying, long term caregiving and bereavement by for example, having at least one of the following:
    • Patient groups, for example, carers, bereaved, people living with life-threatening illnesses or the very old, to meet each other so that they may seek support from each other.
    • Practice volunteers, for example, rotating neighbourhood volunteer groups.
    • Practice register of patients with relevant experience who may wish to be involved.
    • Support to the wider community, for example, offering support to formal and informal carers.
    • Services offered by voluntary sector linked with the practice.
      Services offered by practice (+/- in collaboration) as part of federation, social prescribing or community development services.
  • Social prescribing models aim to unlock assets based with the community that support de-medicalised care and combating issues such as, isolation, depression, anxiety and loneliness.
  • Consider mapping of the local services available to support people in the community with Advanced Serious Illness, and EOLC needs.
  • Consider how PPG champions could support development
  • Consider a local end of life care pathway/contact list template.
  • Consider the local community support groups available.
  • Consider how to support marketing and advertising, enabling community access.
  • Consider local voluntary sector and services offered.
  • Consider how your practice system can actively support people affected by life- limiting illness, death and dying, long term caregiving and bereavement
    • This may be done by encouraging a system for patient groups, for example, carers, bereaved, people living with life-threatening illnesses or the very old, to meet each other so that they may seek support from each other.
  • CCGs ideally could support a centralised, regularly updated local directory of services/charities/support networks.

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QI 8: Continous Improvement

Regular SEA meetings and debrief meetings in order that lessons can be learned from EOLC and deaths. The lessons are shared with the relevant people. Annual evaluation of compassionate organisational culture.

General Continuous Improvement

If an indicator has not been achieved consider utilising a Plan Do Study Act cycle.

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