Working together to improve end of life care:
How were they developed?
The RCGP created the Daffodil Standards in partnership with Marie Curie.
Experienced GPs and healthcare professionals helped to develop the Standards, making sure they fit into the work you’re already doing, rather than adding to your workload.
"Making sure that patients and their families feel supported at the end of life is an essential part of what we do, and in many ways, one of the most privileged aspects of our role"
- Helen Stokes Lampard, Former Chair of the Royal College of GPs (2016-2019)
Why are they important?
- One person dies every minute in the UK annually
- Up to 9 bereaved people are affected by each death
- Most people have a predictable death (60-70%)
- 60-90% of people in the last year of life, have an informal care-giver
GPs lead the majority of care in the community for people with palliative and end of life care needs, with only a small proportion under hospice care. GPs regularly support conversations with people about ‘What Matters Most to the person and their important others’ to enable consistent personalised care and support planning. General Practice plays a key role in the delivery of end of life and bereavement care and is ideally placed to reduce variation in care, regardless of diagnosis, age, ethnic background, sexual orientation, disability or social circumstances.
How do the Daffodil Standards work?
Once you're signed up, you'll receive a welcome pack, including a Daffodil Mark to display in your practice. Plus, you’ll receive Daffodil Updates about free tools and support available to help your work grow.
The Standards (also known as RCGP & Marie Curie UK General Practice Core Standards for Advanced Serious Illness and End of Life Care) cover eight core areas below.
- Professional and competent staff
- Early identification
- Carer Support
- Seamless, planned, coordinated care
- Assessment of unique needs of the patient
- Quality care during the last days of life
- Care after death
- General Practice as hubs within compassionate communities
The Standards can be applied to your whole population affected by end of life care and bereavement or practices can choose to focus on a particular Standard of interest or a cohort of people. For example, Older People in Care Homes was added in 2021.
Where to start?
Whatever your starting level, keep it relevant to your practice, your staff and your patients – every improvement step counts. Small steps and changes can result in significant improvements. ‘Prepare, Plant, Nurture, Bloom!’
In autumn 2021, we refreshed the way practices can interact with the Standards. Based on feedback from GPs, we’ve created a simple three-level approach:
Level 1: Core Essentials
Focusing on internal practice systems to enable consistency of care.
Prepare
- Leadership - Identify practice clinical and non-clinical leads
- Share vision - with practice + MDT
- Look at consistency of practice processes e.g. coding and where information is found in the records
- Collect your practice data
- Example methods: MDT template (prospective and over time becomes an audit) (XLS file, 307 KB) or Retrospective audit (XLS file, 305 KB)
Level 1 All patients EOLC & Bereavement self-assessment template September 2021 (DOCX file, 37 KB)
This offers a framework to build on your care learning.
Level 2: Enhanced
Improving communication, shared planning and compassionate care.
Plant
- Reflect on the data you’ve collected – practice team / MDT - patterns, gaps – self-assess against good practice evidence
- Learn from deaths
- Learn from out-of-hours emergency care
- Themes:
- Communication and involvement
- Planning
Nurture
- Look for areas of improvement
- Create methods for obtaining staff/ MDT and patient /carer feedback
- Set some SMART GOAL(S)
- Plan your change activity in order to get to your SMART GOAL(S)
- Monitor your change and improvement (Re-audit or Keep track on your MDT template)
Level 2 All patients EOLC & Bereavement self-assessment template September 2021 (DOCX file, 38 KB)
This offers a framework to build on your care learning. The template also enables you to deep dive into the quality of information and communications from general practice to patients, family, practice and MDT staff.
Level 3: Advanced
Coproduction of care and compassionate communities. Completion date to be confirmed.
Bloom
Other actions:
- Inform your Primary Care Network / Federation and if you have available, your Patient Participation Group
- Produce a long-term plan for practice ambitions and a timeline (including review points)
England: Does the Care Quality Commission recognise the Daffodil Standards?
The Daffodil Standards are recognised by the CQC in England as a robust framework that evidence the quality of your care.
Sign up your practice today
Help your whole team feel empowered to improve the end of life care you provide in manageable, practical ways which suit you.
By registering you and your practice receive a welcome pack and gain access to key updates, top tips, free webinars and opportunities to share learning within a community of practice. Your Daffodil Standards welcome pack will include notebooks, pens, posters and leaflets for you and your team, as well as the Daffodil Mark, which can be displayed to highlight the practice's commitment to excellent end of life care and support for people with advanced serious illness.
To receive your Daffodil Mark and other useful information to support you as you use the Daffodil Standards, please complete the form linked below.
Sign up for free to the Daffodil Standards
Contact us
For any queries, please contact us.
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