Examples of Changed Practice
From comments made by participating healthcare professionals At verification the following comments were made by healthcare professionals from participating practices. The list is not exhaustive and not every comment was captured but among those made were:-
“Meetings now formalised have been beneficial for improving communication”
“Education could be more integrated for the multidisciplinary team.”
“The gathering of evidence required made the team think that proof of practice could not be easily identified”
“The doctors and nurses have been drawn together to discuss and voice their differences and opinions.”
“Made the team formalise their meetings and identify palliative care for their agenda”
“Made the team focus on support for patients with Cancer and or their palliative care support needs”
“There has been a changed of practice since completion of the self accreditation book, and before the verification visit”
“May well consider palliative care for audit in the future, not prioritised before the accreditation”
“Have addressed issues since completion of the self assessment book. Found it stimulated identification of areas where they had previously no written guidance.”
“Could record better than they do and use the template on the computer for Palliative care.”
“Prompts the practice to discuss/consider issues”.
From observations of the Verification Team.
Having completed verification visits to the practices the following areas were identified by the verification team as areas worthy of consideration for change in practice. Again the list is not exhaustive and not every idea was captured but among those considered were:-
Some practices make more use of IT systems, particularly in relation to the use of
the Intranet and templates.
Appraisals are spasmodic for nurses and practices are not made aware of their teams’ individual educational needs.
Mixed use of guidelines for palliative care, poor awareness of what is available.
A written philosophy for palliative care was not seen as a priority by practices. They all felt that an unwritten philosophy existed around the care of Cancer / Palliative Care patients.
Some practices do not see gathering the evidence as an important or integral part of the process.
Visits have been successful at bringing the ICP to the forefront in general practice, and in identifying areas of interest.
Palliative care was seen as important but was generally accepted to be a very small part of Primary Care.
The process identified the lack of a Cancer lead within the localities.
Recognises the need to develop a trust bereavement proforma for use in primary care.
The information available to patients on Cancer / Palliative Care and on Support groups differs greatly from surgery to surgery.
The district nurse does not always share the medical practitioners perceptions of the team working well together.
Development of a ‘do not resuscitate’ form for general practice is required.
Visits by the Palliative Care consultant is often the only update accessed by the team. This is generally due to time constraints and the geographical difficulties of rural practice. The Macmillan nurse not always considered as a resourse in relation to providing training and education to the team.
Development of a referral form for the Macmillan nursing service is required.