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The GSF Prognostic Indicator Guidance
  1. Keri Thomas
  1. Professor Keri Thomas is National Clinical Lead for the Gold Standards Framework Centre, Honorary Professor End of Life Care, University of Birmingham. Email: keri.thomas{at} For further information:


One of the major barriers to the delivery of good-quality end-of-life care is the fact that people who are approaching the end of their lives are not identified at an early enough stage. Consequently, they and their families are not provided with the support they need. This may lead to poor care provision, inappropriate hospital admissions, preventable suffering or crisis events. This is a particular problem for patients with non-malignant diseases, frailty and dementia as the illness trajectories of such conditions are not as predictable as those of malignant disease. This article provides an overview of the Gold Standards Framework (GSF) Prognostic Indicator Guidance. This guidance was developed by the GSF Central Team to assist generalist clinicians with early identification of people approaching the end stages of their disease process. The guidance provides useful prompts or ‘triggers’ to healthcare professionals, making them aware that supportive measures for end-of-life care should be initiated promptly.

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