An evaluation of the impact of the key information summary on GPs and out-of-hours clinicians in NHS Scotland

Craig, Joyce; Morris, Lilah F.; Cameron, Jonathan; Setters, Jo; Varley, Danielle; Lay, Anna; Thompson, Ian M.

doi:10.1177/0036933015577540

Cited by 11 publications

(17 citation statements)

References 4 publications

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“…In order to ensure that patients can continue to be appropriately identified for and offered high-quality anticipatory care planning, these resource issues need to be considered. GPs were positive about KIS in the interface between themselves and GPs working OOH, as reported in a previous KIS evaluation 18…”

Section: Discussionsupporting

confidence: 72%

Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners

Tapsfield

Hall

Lunan

et al. 2016

BMJ Support Palliat Care

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Section: Discussionsupporting

confidence: 72%

Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners

Tapsfield

Hall

Lunan

et al. 2016

BMJ Support Palliat Care

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“…Interviews with the Carer Liaisons and GPs in the participating sites highlighted the importance of carer support being embedded across whole practices. In GP practices in Scotland, electronic Key Information Summaries (eKIS) (a shared national electronic record to enable sharing of clinical information between unscheduled care staff and GPs [ 17 ]) may be a useful way of identifying carers as part of the anticipatory care planning process, but this may have to be championed by a key worker in the practice. “Key Information Summary, so it’s sharing information with the out of hours, but if you start one of those they’re asking for relatives and next of kin and carer information, so it’s highlighting that sort of information that you need to be providing as well so I guess we’re picking up a lot more than we used to and we’re certainly thinking about it a lot more” (GP) …”

Section: Resultsmentioning

confidence: 99%

Piloting a new approach in primary care to identify, assess and support carers of people with terminal illnesses: a feasibility study

Carduff¹,

Jarvis²,

Highet³

et al. 2016

BMC Fam Pract

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BackgroundGeneral practices in the United Kingdom are encouraged to have a protocol for the identification of carers and a mechanism for social care referral. However, a minority of carers are identified and those caring for someone with a terminal illness often cope until the situation becomes overwhelming. Earlier identification could enable more timely support.The aim of this project was to model and pilot a systematic approach to identify, assess and support carers of people with supportive and palliative care needs in primary care.MethodThe intervention was modelled on the Medical Research Council complex intervention framework with a preliminary theoretical phase, which has been reported elsewhere. In this study, which lasted 12 months, four general practices were recruited. Each practice identified a ‘carer liaison’ person to take the lead in identifying carers, followed by assessment and support using a toolkit modelled from the earlier phase. Qualitative evaluation interviews were conducted with carers who had received the intervention and the carer liaisons and general practitioners in the pilot practices. A stakeholder event was held to disseminate and deliberate the findings.ResultsThe practices’ populations ranged from 5840 to 10832 patients and across the four practices, 83 carers were identified. Thirty six carers were identified from practice registers (disease - 16; palliative care - 9; carer - 11; advanced care plan - 12), whilst 28 were identified opportunistically by practice staff at appointments or at home. Seven carers self-identified. Overall, 81 carers received the carer pack and 25 returned the Carer Support Needs Assessment Tool (CSNAT) form. Eleven carers received a follow up call from the practice to discuss support and 12 were also referred/signposted for support. Qualitative interviews suggest carers valued connection with their practices but the paperwork in the toolkit was onerous.ConclusionThis approach to identifying and supporting carers was acceptable, but success was dependent on engagement within the whole practice. Carers did not tend to self-identify, nor ask for help. Practices need to proactively identify carers using existing opportunities, resources and computer systems, and also adopt a public health approach to raise carer awareness and perceived support within their communities.

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“…The introduction of the new electronic Key Information Summary (KIS) seems likely to significantly affect primary palliative care [ 20 ]. The KIS allows selected parts of the GP electronic patient record to be shared with the wider NHS using a template within the GP clinical system.…”

Section: Discussionmentioning

confidence: 99%

Improving primary palliative care in Scotland: lessons from a mixed methods study

Mason¹,

Buckingham²,

Finucane³

et al. 2015

BMC Fam Pract

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BackgroundSince 2012, all GP practices across Scotland have been supported to take a systematic approach to end-of-life care, by helping them to identify more patients for palliative care through a Palliative Care Directed Enhanced Service (DES). We aimed to understand the impact of this initiative.MethodsRoutine quantitative data from the 2012/13, and 2013/14 DES were collected from regional health boards, analysed and discussed. Qualitative data were collected from a sample of 2012/13 DES returns and analysed using Thematic Analysis.ResultsData were received from 512 practices in nine Scottish Health boards for the 2012-13 DES and 638 practices in 11 Health boards for 2013-14. A sample of 90 of the returns for 2012-13 was selected for qualitative analysis.In 2012-13, 72 % of patients who died of cancer were listed on the palliative care register (PCR) before death while 27 % of patients who died as a result of non-malignant conditions were listed on the PCR. In 2013-14, cancer identification remained the same but identification of people dying with other long-term conditions had improved to 32.5 %.We identified several key issues needed to improve palliative care in the community. The need for training to identify patients with palliative care needs (particularly non-cancer); communication skills training; improvements in sharing information across the NHS; under-resource of and lack of coordination with district nurses; improvements in information technology; and tools for working with enlarged palliative care registers.ConclusionsThe DES helped more patients with long-term conditions (LTC) receive generalist palliative care. Approaching generalist palliative care as anticipatory care could facilitate communication between GPs and patients/families and remove some barriers to early identification of palliative care needs. Improvement of information technology and use of identification tools like the SPICT™ may improve professionals’ communication with each other and help may make identification and management of patients easier.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-015-0391-x) contains supplementary material, which is available to authorized users.

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An evaluation of the impact of the key information summary on GPs and out-of-hours clinicians in NHS Scotland

Cited by 11 publications

References 4 publications

Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners

Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners

Piloting a new approach in primary care to identify, assess and support carers of people with terminal illnesses: a feasibility study

Improving primary palliative care in Scotland: lessons from a mixed methods study

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