Improving End of Life Care - Best Practice Documents and Resources

Sheffield Electronic Palliative Care Communicating System

Sheffield Electronic Palliative Care Communicating System Information is available at http://nww.sheffield.nhs.uk/referrals/?cat=226

The Principles of the Gold Standards Framework

The Gold Standards Framework is a framework of multiple tools, tasks and resources that can be adapted within GP practices and community nursing teams, to improve end of life care for patients with any end stage illness. The principles of which, identify, assess and plan are best practice for end of life care in primary care.

The following flow charts have been developed to support this in practices. In addition the 'Special Notes Form' is available to support communication to the GP Collaborative.

Download the flowchart (40kb pdf, opens in a new window)

Community pathway for patients on palliative care register requiring supportive and palliative care - Part 1 (44kb pdf)

Community pathway for patients on the GSF / palliative register and in the dying phase - Part 2 (46kb pdf)

For further information see the Gold Standards Framework website.

Special Patient Note Information Form (85kb Word)

Care Planning in Advance

Advance care planning is a process of discussion between patients and the clinician caring for them during which views and preferences maybe expressed as to wishes around future care, including care at the end of life. The Preferred Priorities of Care is an example of a document that supports this process and within which preferences and wishes can be recorded.

Preferred Priorities for Care (610kb pdf)

Planning for Your Future Care – A Guide (1.64mb pdf)

Advance care planning guidelines by the Royal College of Physicians (to be added)

If however the wish is to refuse specific treatment consideration should be given to an Advance Decision to Refuse Treatment (ADRT).
Advance Decision to Refuse Treatment: A Guide (151kb pdf)

Sheffield's End of Life Care Pathway

Sheffield's end of life care pathway is an evidence based, continuous quality improvement framework for the delivery of appropriate care for dying patients and relatives, irrespective of the diagnosis or place of death, based on the Liverpool End of Life Care Pathway. It is for the patient in the final phase of life and encourages a multi-professional approach to the delivery of care that focuses on the physical, psychological and spiritual comfort of patients and their relatives. Sheffield's end of life care pathway is currently being rolled out across all care settings in the city.

End of Life Care Pathway – Community (424kb pdf)

End of Life Care Pathway – Hospital (431kb pdf)

End of Life Care Pathway: Information for relatives and friends leaflet (99kb pdf)

Renal Liverpool Care Pathway (Please note: some work has been done nationally to amend the pathway for specific specialities, ie renal)

Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR)

DNACPR seeks to address two general scenarios, those dying from an advanced progressive disease for whom CPR is not a viable treatment option, and those with a life limiting condition for whom CPR may still be a viable treatment option, but wish to refuse CPR in future, the latter is referred to as an Advance Decision to Refuse Treatment. In relation to end of life care it aims to reduce inappropriate CPR attempts and allow a natural death.

NHS Sheffield DNACPR form (31kb pdf)

DNACPR policy (599kb pdf)

DNACPR leaflet (95kb pdf)

DNACPR presentation (239kb pdf)

End of Life Care Events & Education

Joint PBC Consortia - GP and Community Nursing EOLC Events within 2010/11

Practical end of life events aimed to improve the quality of end of life care by enabling protected time for practices and their community nursing colleagues to update their skills and review their management of palliative care registers together.