16 Impact of gold standards framework accreditation on specialist palliative care referrals in acute hospital setting; addressing inequalities in access
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
<h3>Background</h3> It is established that people with a non-cancer diagnosis tend to have less access to supportive and palliative medicine and may have a poorer experience of care in the last phase of their life and this inequality is acknowledged within current end of life care provision. At Dudley Group NHS Foundation Trust (DGFT) we have implemented the Gold Standards Framework (GSF) trust wide, with eight wards achieving GSF accreditation, with continuing engagement across the trust. This review aimed to understand the impact implementing the GSF has had on the hospital specialist palliative care team referrals. <h3>Method</h3> Using PowerBI data analysis a retrospective review of the proportion of referrals by diagnosis group was performed over 16 months from January 2022 to April 2023 alongside the number of referrals. <h3>Results</h3> The review identified an increasing trend in the proportion of patients referred with a non-cancer diagnosis. From as baseline around 25% non-cancer and 75% cancer there has been a clear increase in the non-cancer referral to a 50:50 split. During this 16-month timeframe there was also continued growth in the number of referrals, with the increase driven from the non-cancer diagnosis group with a 48% average increase in referrals per quarter, whilst cancer group referral numbers remained stable (3% average growth per quarter). <h3>Conclusion</h3> This review highlights the benefits of embedding the GSF on improving identification of patients and increasing access to specialist palliative medicine, particularly for non-cancer patients. As a Specialist Hospital Palliative Care service, the local response to increased recognition has included the involvement within local non-cancer multidisciplinary meetings. These findings support the benefits of embedding the GSF to improve upon inequality in access to specialist palliative care for non-cancer patients.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it