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GPs call for improved resources to help practice staff deal with patient deaths

by Costanza Pearce
20 February 2019

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Just 2% of GPs say their practice provides formal support for staff in dealing with grief and loss, new research has revealed.

The study, which surveyed 1,005 GPs last month, was carried out by research organisation ComRes and released to coincide with a new set of standards for end of life care.
The Daffodil Standards, published last week, were developed by the RCGP and terminal illness charity Marie Curie to support primary care teams in delivering end of life care.

The eight standards include making practices ‘hubs within compassionate communities’ and ‘considering staff emotional support needs after their patients die’.

According to ComRes’ findings, seven in ten (71%) GPs agree that there should be more resources available to help practice staff with the grief of losing patients, with three in five (59%) saying their practice does not provide any support or opportunities to share experiences.

This was particularly a problem in Northern Ireland, where three quarters (75%) said they had not been supported in dealing with loss.

While 21% of respondents said ‘regular informal meetings are held in which staff’s grief and loss are discussed’, very few practices were found to be providing formal support.

Only 7% of GPs reported that their practice offered formal debrief sessions for patient deaths and just 2% said there were formal support sessions.

The practice as a ‘compassionate community’

In order to meet standard eight, practices must commit to becoming a ‘compassionate community’, learning lessons from patients and their carers and utilising wider community resources.

The guidance said practice leadership should review how they ‘involve staff to help develop a supportive, caring environment for staff’.

This includes creating an annually reviewed practice plan to actively support staff in loss, as well as conducting a staff survey and holding practice meetings to discuss what supporting the team in dealing with loss might entail.

Regular formal debriefs for all deaths are recommended as part of a practice’s ‘continuous improvement’ alongside an ‘annual evaluation of compassionate organisational culture’.
End of life care lead for the RCGP and Marie Curie Dr Catherine Millington-Sanders said: ‘The Daffodil Standards were created to help support GPs in delivering the best end of life care possible, and that includes making sure our teams feel supported when dealing with serious illness, death and grief – either personally or professionally.

‘The eighth standard – general practice being hubs within ‘compassionate communities’ – embodies this and encourages staff to think about ways in which they can actively support colleagues, patients and families about death, crisis and loss.’

She added: ‘As our survey shows, it’s been very difficult for practice teams to conduct regular, formal debrief sessions when a patient dies – often due to the intense resource pressures currently facing our profession.

‘We hope that these standards support practices not only improve the care they provide to our patients, but also to each other, by communicating better about grief and loss – supporting one another when we need it most.’

Chief executive of Marie Curie Dr Jane Collins said: ‘The new standards will play a key role in excellent end of life care and ensure that busy GPs and practice staff have the support they need to improve the quality of care provided.’

Piloted by 16 practices across the UK, the standards have been recognised by the QOF indicator on end of life care and the CQC.

Practices that sign up commit to making improvements in at least three of the eight standards each year, with the aim of reviewing all of them within three years.