Assessing and improving out-of-hours palliative care in a deprived community: a rapid appraisal study

Author:

Fergus CJY1,Chinn DJ2,Murray SA3

Affiliation:

1. Primary Palliative Care Research Group, University of Edinburgh, UK, Palliative Medicine, Borders General Hospital, Melrose, UK,

2. Research & Development Resource Centre, NHS Fife, Lynebank Hospital, Dunfermline, UK

3. St Columba's Hospice Chair of Primary Palliative Care, Primary Palliative Care Research Group, General Practice Section, University of Edinburgh, Edinburgh, UK

Abstract

Recent changes to out-of-hours primary care in the UK have generated concerns about care for palliative care patients. The aim of this study was to identify key challenges and improvements to out-of-hours palliative care in a mixed urban and rural deprived area. We integrated data from three sources: interviews with patients and professionals, direct observations of services, and routine statistics. Key issues in the provision of care were the importance of good communication and having information available, the unwieldy process of accessing medical care out of hours, professionals bypassing routine out-of-hours care for palliative care patients, and out-of-hours care being provided by practitioners unaware of local services. We recommend provision to out-of-hours services of an enhanced ‘special note’ for palliative care patients, to be completed early in the course of the illness and updated regularly. The provision for certain complex patients to bypass NHS24 should be considered if routine care is not satisfactory.

Publisher

SAGE Publications

Subject

Anesthesiology and Pain Medicine,General Medicine

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