Table 4 Levels of GSF adoption for practices participating in observations and related health professional interviews
Key tasks | Practice A | Practice B | Practice C |
|---|---|---|---|
Communication | Set up register Regular GSF meetings | Set up register Less regular GSF meetings | Set up register Regular GSF meetings |
Co-ordination | Lead GP has special interest and is responsible for coordinating meeting and register DN input from DN team, no specific lead DN | Lead GP has special interest and is responsible for coordinating meeting and registerLead DN for practice | GP lead has no ownership, CNS is responsible for coordinating meeting and highlighting patients for register Lead DN for practice |
Control of symptoms | Confident in symptom control and pool knowledge with other services Do not routinely use assessment tools | Lack of confidence in symptom control, but shared care with/supported by CNS and DN services Use assessment tools | Lack of confidence in symptom control and leave care to other services Lack of use of assessment tools |
Continuity of care | Shared care with secondary care | Shared care with secondary care | Lack of continuity of care with secondary care, will not take responsibility of care or participate in shared care |
Continued learning | Use of significant/after death analysis Identify and address knowledge gaps | Use of significant/after death analysis but infrequency of meetings impinges on this | Do not carry out continued learning unless instigated and led by CNS |
Carer support | Carer support Extend care into bereavement phase | Carer support evident but infrequency of meetings impinges on this Extend care into bereavement phase | Carer and bereavement support left to CNS and not discussed within practice |
Care in the dying phase | Involved in dying phase | Involved in dying phase | Reluctance to engage in dying phase |