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Table 2 The four levels of adoption of the GSF

From: Primary palliative care team perspectives on coordinating and managing people with advanced cancer in the community: a qualitative study

Level 1

Communication

Compiling and maintaining a supportive care register to record, plan, and monitor patient care

Coordination

Having a nominated coordinator to oversee implementation and maintenance of the framework

Level 2

Control of symptoms

Patients’ symptoms, problems, concerns are assessed, recorded, discussed and acted upon to an agreed process. Advanced care planning tools are recommended

Continuity

Systems to ensure continuity of care delivered by inter-professional teams and out-of-hours providers are used. Anticipatory care in place to reduce crises and inappropriate admissions

Continued learning

Commitment to learning about end-of-life care and developing action plans to meet identified learning needs. Reflection on past events, what went well and why, and what did not go well and why

Level 3

Carer support

Work in partnership with carer and assess and support their needs for emotional, practical, and bereavement support

Care of the dying

Appropriate care provided in the last days of life

Level 4

Sustain, embed and extend improvements in end-of-life care

Sustain and build on all developments as standard practice. Develop a practice protocol and extend to other settings, e.g.: care homes, non-cancer, ACP