| Medical Foundation for AIDS & Sexual Health | |
| This site tells you about our work with health professionals and policy-makers and provides links to a wide range of other useful sources of information. Find out more about us. |
|
|||||||||
 |
|||||||||
|
London sexual health needs assessment & service mapping
HIV for non-HIV specialists
Progress and priorities - working together for high quality sexual health
Royal College of General Practitioners: Introductory Certificate in Sexual Health The next training events will be held on Friday 26 June 2009 in Manchester, and Friday 25 September 2009 in London. For more information on the course, or to reserve a place click here for the registration form.
UK National Guidelines for HIV testing 2008
10 high impact changes for genitourinary medicine 48-hour access
|
|||||||||
http://www.medfash.org.uk/
www.medfash.org.uk/publications/documents/Recommended_standards_for_
PDF version The standard of care of the terminally ill in the NHS in England has been criticised by MPs.
Palliative care has been given a low priority, said members of the Committee of Public Accounts.
They said lack of services and poor co-ordination of health and social care meant many people were denied their wish to die at home.
NHS end of life care was also criticised in a National Audit Office report published last November.
Approximately 500,000 people die in England each year, and around 75% of these deaths follow a period of chronic illness.
Although most people would rather die at home, the majority (60%) end their days in hospital - even though there is no clinical need for them to be there.
The MPs said front line health workers often lacked training in basic end of life care.
They said people who died in hospital did not always receive first rate care, such as the most effective pain management, and were not always treated with dignity and respect.
The MPs also highlighted problems of poor co-ordination between different branches of the caring professions which meant that the wishes of terminally ill patients were often not known.
And even when a patient had made it clear they wanted to die at home, that wish was often not satisfied because of a lack of services to care for them outside hospital.
Protected funds
Committee chairman Edward Leigh said: "It is appalling that people dying in hospital are not always being given the end of life care they deserve, including effective pain management and being treated with dignity and respect."
<!-- S IBOX -->
 |
 Age discrimination continues to haunt older people even at the end of their lives  Michelle Mitchell
Age Concern and Help the Aged |
<!-- E IBOX -->
Mr Leigh said the government had made new funds available for palliative care, but said primary care trusts must ensure the cash was spent on improvements to the service, and not diverted to other areas.
They said hospices should be given an expanded role, offering training to care home staff and outreach services to improve the quality of care for people in their last year of life.
The MPs also warned that the provision of end of life care was becoming increasingly complex, with people living longer and developing multiple health problems.
Thomas Hughes-Hallett, chief executive of Marie Curie Cancer Care, said work carried out by the charity had shown that if health and social care agencies worked together the number of people able to die at home could be doubled at no extra cost.
He said: "This report again highlights the need for better end of life care."
Age discrimination
Michelle Mitchell, director for Age Concern and Help the Aged, said: "Age discrimination continues to haunt older people even at the end of their lives.
"Towards the end of life, older people often need support from a range of health and social care services, however availability is patchy, staff lack training and coordination can be poor.
"Because of this, older people who wish to die in familiar surroundings at home often die in hospital and suffer needlessly from lapses in standards of care."
Care services minister Phil Hope said the government had already committed to investing £286m over three years to back up its End of Life Care Strategy published last year.
He said: "People coming to the end of their lives deserve high quality, compassionate and dignified care, on their own terms.
"Guidance issued to primary care trusts has made it clear that we expect the extra funding to be used for end of life care services. The NHS locally should have proper monitoring in place to make sure this happens."
Healthcare
Get information and advice to help guide you when finding and using healthcare services.
HIV infection presents great difficulties for those living with the virus and tough challenges for those providing their care. While we have seen dramatic improvements in health and quality of life for many since the introduction of highly active antiretroviral therapy (HAART), we are also faced with sharp rises in the number of people infected and seeking care. The stigma and discrimination still associated with HIV are compounded by the social exclusion experienced by significant numbers of those infected. Their needs are not only for medication, but for a range of integrated health and social care services. About a third of those with HIV do not even know they are infected and risk severe illness following missed opportunities for diagnosis. New and developing HIV service networks should address these challenges, engaging professionals across disciplines and specialties along with people living with HIV.
Download Booklet PDF File [652 Kb]
http://www.chiva.org.uk/publications/standards.html
Welcome to the website of the National Gold Standards Framework (GSF) Centre England
|
National GSF Spring 2009 Bi-Monthly Update Please see several new updated documents available in the Latest New section eg, Prognostic Indicator Guidance (PIG), After Death Analysis (ADA) Briefing Paper and Going for Gold |
|
The Gold Standards Framework (GSF) is a framework to enable a gold standard of care for all people nearing the end of their lives. |
GSF is a systematic evidence based approach to optimising the care for patients nearing the end of life in the community. It is concerned with helping people to live well until the end of life and includes care in the final year of life for people with any end stage illness.
|
|
The aim of the Gold Standards Framework (GSF) is to develop a locally-based system to improve and optimise the organisation and quality of care for patients and their carers in the last year of life.
|
|---|
GSF developed in 2001 from clinical experience in primary care, as a grass roots initiative to improve primary palliative care and collaboration with specialists. Since 2004 the framework has been adapted for use in care homes and a new GSF in Care Homes programme has been developed.
From November 2007 the GSF team became the National GSF Centre and moved to new host Walsall tPCT. A GSF Position Paper was written in October 2007 setting out the achievements to date and plans for the future.
There are 3 Programmes of work from the GSF Centre:
1) GSF Primary Care Programme
GSF in Primary Care Programme is a framework of multiple tools, tasks and resources, which can be adapted within GP practices and community nursing teams, to improve end of life care for patients with any end stage illness. The GSF in Primary Care programme is structured into 4 levels of adoption, an additional Beacon level in development. In 2007 90% of practices nationally were claiming to Quality and Outcomes Framework palliative care points in the GP Contract (equates to 90% adoption of GSF Level 1). The other independent survey indicates that 60% are using GSF.
National University based and local audits across the country evaluation has shown that communication and co-ordination of end of life care within primary care improves with GSF - as well as an improvement in numbers of patient's dying at home and an associated reduction in patients dying in hospital.
GSF in primary care is best introduced, developed and integrated into practice when supported by the National GSF resources and local support. See How to get involved for more information on registering with the GSF Primary Care programme and Care Homes for the GSF in Care Homes programme.
2) GSF in Care Homes Programme
The GSF in Care Homes (GSFCH) programme is a structured 3 stage training programme. The aims are:
-
to improve the quality of care for people nearing the end of life in care homes;
-
to improve collaboration between care homes, GPs/Primary Care Teams and Specialist Palliative Care Teams and
-
to reduce the number of admissions to hospital in the last stages of life and enable more to die in the care home.
Evaluation to date has shown improved quality of care provided, improved staff confidenece, improved processes/documentation, plus a 12% decrease in crisis hospital admissions and an 8% decrease in hospital deaths (sample size 437 patients - see GSFCH Briefing Paper 1 March 07)
Other GSF - related
3) End of Life Care Support Programme - with our new Charity Omega
To date this has included:
-
Development of end of life care strategies and implementation plan for PCTs, and areas with full guidance on usage
-
Needs support matrix
-
Development of Prognostic Indicator Guidance to support better identification of patients in need of supportive care (suitable for the register) focusing on those with non-cancer diagnosis
-
Advance Care Planning 'Thinking ahead' document and guidance to support improvements in proactive care planning
|
'GSF is the bedrock of generalist palliative care' - End of Life Care Facilitator Norfolk 2006 'This will mean extending the roll-out of tools such as the Gold Standards Framework and the Liverpool Care Pathway for the dying to cover the whole country' - NHS White Paper January 2006 |
|
1 The Aim of the Gold Standards Framework (GSF) is to develop a locally-based system to improve and optimise the organisation and quality of care for patients and their carers in the last year of life. One chance to aim for the best for all – one ‘Gold Standard’ to aspire to for ALL patients nearing the end of life, whatever the diagnosis, stage or setting. 3 Processes of GSF - all involving improved communication, are to:
5 Goals of GSF are to provide high quality care for people in the final months of life in the community with:
7 Key Tasks or standards to aim for - the 7 C’s - see GSF in Practice for each of the specific tasks below:
|
|
|
'The College is pleased to support the Gold Standards Framework, which is having a huge impact on the quality of care at the end of patients' lives. The values expressed in this framework are central to the College ethos of Knowledge with Compassion.' (Dr Graham Archard Vice Chairman Royal College of General Practitioners, March 05)
|
|---|
"GSF has enabled me to do the job of District Nurse I'd always wanted to do"
"GSF is magic! It is MUCH more than it first appears - it is like a key that unlocks the creativity of people, and releases the potential for a new way of working for the whole team. It helps us do what we already want to do, but even better. Now we really do talk to each other - it has transformed the way we care for our very ill patients, and has put us back in touch with the reasons we are doing this job in the first place."
GP and DN West Midlands
"We hope that the widespread dissemination of the Gold Standards Framework as a tool to ensure that information follows the patient will do something to address the major issue of communication failure in some palliative care."
House of Commons Health Committee Palliative Care July 2004
"One of the ways we can measure ourselves as a society and as a healthcare system is in the way we care for our weakest, including our dying patients. We must regard care of the dying therefore, as a measure of our success and not of our failure, within the NHS. Despite many examples of excellence, good care for the dying in this country is still very much a matter of luck. Using GSF to improve care in the community is one of the building blocks on which we can develop a comprehensive and reliable national end of life care strategy, and so reduce the element of luck, and enable all to receive best quality care at the end of their lives."
"Caring for the dying is a challenging but rewarding business. The GSF is a common sense means of optimising what we do in primary care to enable us to give the best care we can for dying patients in the community."
Dr Keri Thomas - NHS National Clinical Lead for Palliative Care, GPwSI and Clinical Director Community Palliative Care Birmingham
http://www.goldstandardsframework.nhs.uk/
Standards for Quality HIV Care: a Tool for Quality Assessment, Improvement, and Accreditation
Report of a WHO Consultation Meeting on the Accreditation of Health Service Facilities for HIV Care
Reference number: ISBN 92 4 159255 9
In order to provide quality care for People Living with HIV/AIDS and to facilitate to achieve the target of WHO's key initiative, the Treat 3 million by 2005 (“3 by 5”), WHO collaborated with many partner organizations to develop 'Standards for quality HIV care: a tool for quality assessment, improvement and accreditation'.
This publication and the proposed standards are intended for WHO Member States and their authorizing bodies in developing their own framework of accreditation as a guiding principle to improve the quality of HIV care at all levels of health care facilities of the country, with a special focus on antiretroviral therapy. It also offers guidance for the managers and the quality improvement professionals within HIV health service facilities to improve their health services related to antiretroviral therapy.
Download file in English [pdf 347kb]
Download file in French [pdf 213kb]
http://www.who.int/hiv/pub/prev_care/accreditation/en/
Accessing palliative care
When there is no cure for an illness, palliative care tries to make the end of a person’s life as comfortable as possible. This is done by attempting to relieve pain and other distressing symptoms while providing psychological, social and spiritual support. Carers and family are also offered emotional and spiritual support. This is called a 'holistic' approach to care.
Some people with conditions such as cancer can live for many years but they sometimes need treatments such as radiotherapy or chemotherapy to help keep their condition under control. Palliative care can be offered following such treatments or, in the earlier stages of an illness, alongside other treatments. This can be particularly important for children and young people who may live with a life-limiting condition for a long time.
The person you're looking after can receive palliative care:
- in a hospice,
- at their own home,
- as a day patient in a hospice, or
- in a hospital.
Hospice care
Most palliative care is provided in a specialist residential unit called a hospice. Hospices are run by a team of doctors, nurses, social workers, counsellors and trained volunteers. They are smaller and quieter than hospitals and feel more like a home. Hospices can provide individual care more suited to the person in a gentler and calmer atmosphere.
There is no charge for hospice care, but the person you're looking after must be referred to a hospice through their GP, hospital doctor or district nurse.
At home
The person you're looking after may not need to move away from home to benefit from palliative care. Hospice staff are often on-call 24 hours a day and can visit them at home. Your GP can arrange for community palliative care nurses, such as Macmillan nurses, to provide care at home.
Palliative care nurses can offer you advice on how to manage the symptoms of the illness to help you provide better care for the patient you're looking after. They can offer practical, psychological and emotional support, and be accessed through district nurses or a person’s GP.
The social services department of your local authority may provide a range of social care services and equipment to help terminally ill people remain at home.
As a day patient
The person you're looking after may prefer to remain at home but visit a hospice during the day. This means they can receive the care and support they need without moving away from home.
As a day patient they will be able to access more services than could be offered if they stayed at home. These include creative and complementary therapies and rehabilitation, as well as nursing and medical care. They will also meet other patients. Hospices often provide transport to and from the hospice.
In hospital
Specialist palliative care teams are also available in hospitals. They are sometimes called the Macmillan support team or symptom control team. They can include doctors, nurses, social workers and chaplains, or the service can be provided by a single nurse.
The service provides education, training and specialist advice on pain and symptom management to hospital staff. They advise staff on the patient’s discharge plan or transfer to a hospice, community hospital or care home. They also provide emotional support directly to patients and carers.
http://www.nhs.uk/CarersDirect/guide/bereavement/Pages/Accessingpalliati...
Health Secretary Andy Burnham says Labour hopes to scrap hospital parking charges for in-patients in England if the party wins the next election.
He said patients would get a permit to cover the length of their stay which visitors could use to park free.
But campaigners said the move did not go far enough as in-patients, who tend to require the most complex care, only represent a fraction of total patients.
Wales and Scotland are both scrapping fees for everyone.
<!-- E SF -->
This has already happened in most instances, although under the terms of contracts signed with private firms to fund the building of new hospitals it will take several years to ensure parking is free across the board.
<!-- S IBOX -->
|
We are disappointed that they have ignored the same high cost of parking charges to those cancer patients having treatment as out-patients Ciaran Devane, Macmillan Cancer Support
|
<!-- E IBOX -->
In England, discounts - and even free passes - are already available for people needing to make repeat visits to hospitals, such as cancer patients.
NHS trusts have always maintained that some level parking charges was necessary to ensure core health funds were not diverted towards managing and maintaining car parks.
But the variation in procedures across the UK has caused controversy among patient groups.
And even though the health secretary has now intervened, many NHS trusts will still not be compelled to act because they have foundation trust status which gives them autonomy from central government.
New legislation would be required if ministers wanted to force this through.
What is more, in-patients only represent a small number of overall hospital users.
For example, there are about five times as many out-patient visits as in-patient ones.
Nonetheless, Mr Burnham said the move would make a big difference.
"When people are coming into hospital the last thing they want to worry about is keeping the car park ticket machine up to date.
"It's not right if some people don't get visitors every day because their families can't afford the parking fees."
Ciaran Devane, of Macmillan Cancer Support, said: "We applaud the government for recognising the high cost to families visiting relatives in hospitals."
But he added: "We are disappointed that they have ignored the same high cost of parking charges to those cancer patients having treatment as out-patients."
http://news.bbc.co.uk/1/hi/health/8282730.stm
End of life information
-
What to do when someone diesBrief‚ practical information about the things you need to do when someone dies and where to go for more help and advice.
-
Putting your affairs in orderThis guide looks at how you can plan for the future and make sure your wishes are carried out.
- Advance decisions‚ advance statements and living wills - IS5
- Benefits for people under State Pension age - FS56
- Civil Partnership & same-sex couples - IS28
- Dealing with someone's estate - FS14
- Death and Dying in France - IS31
- Instructions for my next-of-kin and executors on my death - IS18
- Later life as and older lesbian‚ gay or bisexual person
- Making a will - FS7
- Older same-sex couples and benefits - IS27
- Planning for a funeral - FS27
- Planning for later life as a lesbian‚ gay man or bisexual person - IS8
- Planning for later life: transgender people - IS30
- What to do when someone dies
http://www.ageconcern.org.uk/AgeConcern/end_of_life_information.asp
Health information
-
Keeping cool in a heatwaveIn the summer‚ very high temperatures and humidity can present risks to health‚ and older people are particularly susceptible to heat-related illnesses.
-
What to expect as you get olderThis guide aims to identify changes you are likely to notice as you get older.
-
Going soloThis guide aims to help you make the transition from being with another person to living by yourself.
-
Your guide to healthy livingThis guide highlights the importance of keeping active.
-
Going into hospitalThis information guide covers what to expect while in hospital and what support can be arranged when you are ready to be discharged.
-
Your health servicesThis information guide tells you what NHS services are available‚ how to find them and what questions to ask to get the most out of them.
-
Winter wrapped upWinter and the cold weather it brings are a source of worry to many older people. Preparing for winter and then following some simple suggestions can help you stay healthy‚ safe and as comfortable as possible.
- Care home checklist
- Dental care - NHS and private treatment - FS5
- Deprivation of Liberty Safeguards - FS62
- Disability and ageing: your rights to social services - FS32
- Disability equipment and how to get it - FS42
- Help with continence - FS23
- Help with health costs - FS61
- Help with health costs - IS20
- Hospital discharge arrangements - FS37
- Keeping cool in a heatwave
- Local NHS services - FS44
- Making the most of your money
- Moving back to the United Kingdom - IS2
- NHS continuing health care and NHS-funded nursing care - FS20
- Paying for temporary care in a care home - FS58
- Planning for later life as a lesbian‚ gay man or bisexual person - IS8
- Planning for later life: transgender people - IS30
- Planning to live abroad
- Resolving problems and making a complaint about NHS care - FS66
- Staying healthy in later life - FS45
- Tenants' rights - repairs - FS67
- What to expect as you get older
- Winter wrapped up
- Your guide to healthy living
<!-- Tag for Activity Group: Age Concern General, Activity: Pensions Information --> <!-- Start of DoubleClick Spotlight Tag: Please do not remove--> <!-- Activity Name for this tag is:Pensions Information --> <!-- Web site URL where tag should be placed: http://www.ageconcern.org.uk/AgeConcern/income_pensions_information.asp --> <!-- Creation Date:08/23/07 -->
http://www.ageconcern.org.uk/AgeConcern/health_information.asp
www.rcplondon.ac.uk/news/statements/hiv-clinical-care.pdf
www.who.int/hrh/documents/en/HRH_ART_paper.pdf