A Derby GP practice that supports nearly two thirds of its patients to die in their preferred place has been rewarded with a prestigious national award.
Macklin Street Surgery was presented with the Quality Hallmark Award at the National Gold Standards Framework (GSF) Conference in London by Dr Catherine Millington-Sanders, Royal College of General Practitioners End of Life Care Champion. It becomes the first practice in Derbyshire to receive the honour.
Dr Sally Giovanelli, one of six partners in the practice that looks after 10,850 patients, said “I’ve been here for 15 years, and seen a number of my patients through to the end of their life. It is a humbling and incredibly rewarding experience and is also one of the most important aspects of care that we provide as GPs. We are passionate about providing the best care we can for our patients, particularly in the final months of their life. Ensuring our patients have a ‘good’ death is really important to their families.
“GSF has really helped us to have a good structure in place and given everyone in the practice the confidence to initiate what can be difficult conversations with people about where and how they want to be cared for and that means everyone feels more in control.”
GSF gives outstanding training to all those providing end of life care to ensure better lives for people and recognised standards of care. It is the largest national programme to help improve care for patients approaching the end of life, helping health and social care professionals provide coordinated, personalised care for patients and their families and reduces hospital admissions.
Helping clinicians identify patients approaching the last year of life is one of the key components of the GSF training. Since completing the training programme Macklin Street has increased the number of patients on its palliative care register from 25 to 70.
Having identified these patients, the clinicians can then engage them and their families in conversations about their care preferences. And 95% of those patients on the register at Macklin Street have had formal discussions about how and where they would like to be cared for as part of an Advanced Care Plan. These patients are known in the practice as gold patients, have direct access to a doctor and their wishes are shared with both the Out of Hours service and the local hospital, the Royal Derby with whom Macklin Street enjoys a close working relationship. Together this helps provide continuity for patient and their family.
Dr Giovanelli and her colleagues are proud that almost two thirds of their patients (62.5%) who die, are doing so in their preferred place.
Macklin Street Surgery is also working closely with four local care homes, helping them provide the best possible care for their residents as they approach the end of their lives.
It’s not just the patients that have benefitted; Macklin Street has significantly increased the number of carers whose needs it assesses offered bereavement support and information.
Lynn Woods, Chief Nurse & Director of Quality for NHS Southern Derbyshire Clinical Commissioning Group, of which Macklin Street Surgery is a member GP practice, said: “We’re proud Macklin Street Surgery has been honoured with this award.
“A key priority for us as a CCG is to help people die in their preferred place, whether that be at home, in hospital or somewhere else, and support activities which help our professionals follow the national ‘One Chance to Get it Right’ guidance to help people end their life in the way they choose, with dignity.
“I’d like to congratulate everyone involved in winning this accolade.”
Professor Keri Thomas, Clinical Director of the National GSF Centre, said: “Macklin Street Surgery has demonstrated a real passion for providing quality care for its patients who are approaching the end of their lives, most importantly helping those patients live their final months in the place and manner of their choosing.
“With responsibility for the coordination of care of vulnerable adults now falling to named GPs, GSF provides the tools, framework and structural change to help family doctors provide ‘gold standard’ care for people nearing the end of life.”
From left, Andrea Jones, Sally Giovannelli, and Anne Armstrong from Macklin Street Surgery, with Sir Muir Gray, Director of the National Knowledge Service and Chief Knowledge Officer to the National Health Service.