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Inadequate example: Working with other organisations/multi-disciplinary team working, communication

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Key question: effective?

Population group: All groups

This example relates to Key Line of Enquiry (KLOE) E4: How well do staff and services work together to deliver effective care and treatment?

When we inspected

Practice 1

There was no evidence of meetings with other health or social care professionals and no reported links with district nurses, community matrons, the community mental health team or community staff who co-ordinate end of life care.

Practice 2

The practice did not have an up-to-date cancer register, nor names and details of patients who may be expected to pass away overnight or at the weekend. In addition, the details of their carer or next of kin were not shared with out-of-hours services.

Locum GPs were not attending multi-disciplinary team meetings to discuss support for patients who required end of life care.

Why this is inadequate?

In the first example, there are no systems to coordinate patients’ care across the wider team, and no formal evidence that it is being done on an individual basis. In the second example, there is no linking in with other agencies providing care for terminally ill patients.

The care and treatment for patients in these practices, in particular the vulnerable end of life patients, are not likely to be well coordinated which will impact the quality of care they receive from the practice.

Information and guidance

Last updated:
10 August 2017


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