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Implementation and impact of the Gold Standards Framework in community palliative care: a qualitative study of three primary care trusts

Department of Health Research Training Fellow,* School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; RCUK Research Fellow, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester catherine.walshe{at}manchester.ac.uk

A Caress

School of Nursing, Midwifery and Social Work, University of Manchester, Manchester

C Chew-Graham

School of Community Based Medicine, University of Manchester, Manchester

C Todd

School of Nursing, Midwifery and Social Work, University of Manchester, Manchester

The Gold Standards Framework (GSF) has been widely adopted within UK general practices, yet there is little understanding of its impact on the provision of community palliative care services. This study presents data on the anticipation and adoption of the GSF within three Primary Care Trusts in North West England. Forty-seven interviews were conducted with generalist and specialist palliative and primary care professionals. Important aspects of the GSF identified were the patient register, communication and out-of-hours protocols. Positive benefits to professionals included improved communication between professionals and appropriate anticipatory prescribing. Negative aspects included increased nursing workload and the possibility of fewer or later visits for patients. Many respondents believed that the GSF needed local champions to be sustainable. Slow or incomplete adoption was reported. The GSF was recognised as important because it facilitated changes to previously difficult aspects of work between professionals, but few respondents reported direct benefits to patient care.

Key Words: home care services • interdisciplinary communication • palliative care • physicians • family • primary health care • qualitative research

Palliative Medicine, Vol. 22, No. 6, 736-743 (2008)
DOI: 10.1177/0269216308094103


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