Impact of gold standards framework accreditation on specialist palliative care referrals in acute hospital setting; addressing inequalities in access.

Abstract

It is established that people with a non-cancer diagnosis tend to have less access to supportive and palliative medicine and may have a poorer experience of care in the last phase of their life and this inequality is acknowledged within current end of life care provision. At Dudley Group NHS Foundation Trust (DGFT) we have implemented the Gold Standards Framework (GSF) trust wide, with eight wards achieving GSF accreditation, with continuing engagement across the trust. This review aimed to understand the impact implementing the GSF has had on the hospital specialist palliative care team referrals. Method Using PowerBI data analysis a retrospective review of the proportion of referrals by diagnosis group was performed over 16 months from January 2022 to April 2023 alongside the number of referrals. Results The review identified an increasing trend in the proportion of patients referred with a non-cancer diagnosis. From as baseline around 25% non-cancer and 75% cancer there has been a clear increase in the non-cancer referral to a 50:50 split. During this 16-month timeframe there was also continued growth in the number of referrals, with the increase driven from the non-cancer diagnosis group with a 48% average increase in referrals per quarter, whilst cancer group referral numbers remained stable (3% average growth per quarter). Conclusion This review highlights the benefits of embedding the GSF on improving identification of patients and increasing access to specialist palliative medicine, particularly for noncancer patients. As a Specialist Hospital Palliative Care service, the local response to increased recognition has included the involvement within local non-cancer multidisciplinary meetings. These findings support the benefits of embedding the GSF to improve upon inequality in access to specialist palliative care for non-cancer patients.