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www.mddus.com DEATH CERTIFICATION E-TRAINING


DOCTORS in Scotland are being encouraged to complete two e-learning modules on death certification. The modules have been produced by NHS Education for Scotland (NES) in partnership with Healthcare Improvement Scotland’s Death Certification Review Service (DCRS) and are designed to support certifying doctors to complete Medical Certificates of Cause of Death (MCCDs). Module 1 is entitled Death


Certification: Identifying Common Mistakes and is intended for doctors who are completing MCCDs in Scotland or doctors who have finished a training module on death certification and wish to confirm or improve their


understanding of the subject. Module 2 – Certification of Deaths in


the Community – is primarily intended for doctors who are working in general practice in Scotland and may need to deal with sudden or expected deaths in the community.


DCRS Senior Medical Reviewer Dr


George Fernie said: “These modules are a key component in helping DCRS to deliver its overall aim of improving the quality and accuracy of MCCDs and we would encourage certifying doctors to log on and complete them as a matter of priority.” Access the modules at: www.sad.


scot.nhs.uk/atafter-death/death- certification


NEW STANDARDS


FOR END OF LIFE CARE A NEW set of standards in providing end of life care has been agreed for GP practices. The Royal College of GPs has joined forces with charity Marie Curie to create the Daffodil Standards, designed to support primary care teams in caring for patients living with an advanced, serious illness, or at the end of their lives, and their loved ones. Practices who adopt the eight standards commit to making improvements in at least three of the eight core aspects of care each year, with the aim of having reviewed all of them within three years. Those practices will also be able to display a “daffodil mark” to show their commitment.


The Daffodil Standards are: 1. 2. 3. 4.


Professional and competent staff


Early identification of patients and carers Carer support - before and after death Seamless, planned, co-ordinated care


5. Assessment of unique needs of the patient 6. 7.


Quality care during the last days of life Care after death


8. General practices being hubs within compassionate communities.


A survey carried out to coincide with the launch


found that 92 per cent of GPs agreed it is important for them to spend time caring for terminally ill or dying patients, and another 87 per cent said that caring for terminally ill or dying patients is a rewarding part of their job. However, it also revealed an overwhelming majority


of GPs (85 per cent) felt they did not have as much time as they would like to care for patients at the end of their life because of their workload. Sixty-two per cent said there were not enough community resources to give families and carers of terminally ill or dying patients the emotional support that they need. Similarly, 71 per cent of respondents said more


resources were needed to help GPs and practice staff to cope with the grief of losing patients. Only two per cent said their practice held formal support sessions on dealing with grief and loss. RCGP chair Professor Helen Stokes-Lampard


GENDER REASSIGNMENT SHOULD


BE INITIATED IN SPECIALIST CARE GENDER reassignment is a specialist area of medicine and treatment for trans patients should be initiated in specialist care, says the Royal College of GPs. RCGP honorary secretary Dr Jonathan


Leach said trans patients, like all patients, should be treated in general practice “on the basis of need and without bias.”


He said it is important that GPs and


their teams are mindful of the terminology and language they use when talking to trans patients, and that it should be based on each patient’s individual preference, as well as any individual health needs they may have. But he emphasised that new


presentations of gender reassignment are “exceptional” in general practice, adding: “It is a specialist area of


medicine, and treatment should be initiated in specialist care.” He acknowledged that access to specialist gender reassignment services in the NHS was “inadequate”, and that was frustrating for trans patients and their families. But he said: “GPs should not have to bear the brunt of poor access to specialist services by being put in a position where they are being asked to prescribe treatment that they are not trained to prescribe or monitor safely without expert support.” A new RCGP e-learning course for GPs on gender variance is due to be launched later in 2019. It has also received funding from the Government Equalities Office to develop resources to support GPs and other healthcare professionals to deliver quality care for LGBT+ patients.


welcomed the standards. She said: “Making sure that patients and their families feel supported at the end of life is an essential part of what we do, and in many ways, one of the most privileged aspects of our role.” But she called for more funding to help GPs deal with rising demand. The standards, which have already been recognised


by the new Quality and Outcomes Framework (QOF) on end of life care and the CQC, have been piloted by a number of surgeries across the UK. Each standard comes with its own evidence-based tools, exercises and quality improvement steps. Find out more at:


www.rcgp.org.uk/ daffodilstandards


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