As part of the GMS contract for 2019/20 a new 'Quality Improvement' domain has been introduced which includes 'End of Life Care'.

End of Life Care

Achievement thresholds 
QI003. The contractor can demonstrate continuous quality improvement activity focused upon end of life care as specified in the QOF guidance.
QI004. The contractor has participated in network activity to regularly share and discuss learning from quality improvement activity as specified in the QOF guidance. This would usually include participating in a minimum of two peer review meetings.


Practices will need to: 

  • Evaluate the current quality of their end of life care and identify areas for improvement – this would usually include a retrospective death audit (QI003) 
  • Identify quality improvement activities and set improvement goals to improve performance (QI003) 
  • Implement the improvement plan (QI003) 
  • Participate in a minimum of 2 GP network peer review meetings (QI004) 
  • Complete the QI monitoring template in relation to this module (QI003 + QI004) 

How to do a retrospective death baseline analysis (audit)

Practices should review a sample of X deaths over the previous 12 months to establish baseline performance on the areas of care listed above and to calculate their expected palliative care register size. A suggested template to support data

collection for the audit can be downloaded from here. The number of deaths each year will vary between individual practices due to differences in the demographics of the practice population. Practices could use the number of deaths reported in their practice populations in the previous year to assess how well they are identifying patients who would benefit from end of life care. An audit standard against which to assess current practice would be that the practice was successfully anticipating approximately 60% of deaths.

There are reports available which can be accessed at 'Ardens > Conditions | Frailty and End of Life > Activity Last Year'. 

Information about the Ardens 'End of Life and Palliative Care' template can be found here.  

End of Life register reports are available at 'Ardens > Team | Meetings > End of Life'.

End of Life Report Output

To enable practices to breakdown data quickly and easily there is a report output setup called 'End of Life'.  

How to use a Report Output

  • Run your chosen report 
  • Right click on the report and select  'Show Patients' 
  • Just above the report list click on 'Select Output' 
  • A new window will open, select 'Pre-defined report output
  • Select 'End of Life' and click 'OK'

You should then be able see all the relevant data on one screen which you can easily export to excel.