How do we provide high quality palliative care in the community?

 

 

By Dr Tanuka Palit, NIHR Academic Clinical Fellow in Primary Care, Centre for Academic Primary Care, University of Bristol

“You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die.” Dame Cicely Saunders

Many people express a wish to die at home. The proportion of deaths that occurred in the community (including private homes and care homes) rose significantly during the pandemic and has been sustained. As a consequence, the need to fund and improve our community palliative care services has never been more important. Earlier this year, this was recognised by a change in the Health and Social Care Bill to fund palliative care services in all areas. This will hopefully remove the postcode lottery that currently exists in the UK for these services.

Palliative care in the community is mostly delivered by GPs and community nursing teams, supported by specialist palliative care services. High quality palliative care is achieved when patients “receive the right help, at the right time and from the right people. The team should know a patient’s needs and plans, and work together to achieve this. And they should always be able to reach someone who will listen day and night.”

We know that patients value continuity and coordination of their care from these professionals. And we also know that multidisciplinary care is at the heart of good palliative care. However, with changes to the way GPs are working after the coronavirus pandemic, and with the ongoing issues of staff recruitment and retention, how are we doing in providing this holistic care?

Our qualitative interview study aims to explore the current roles and relationships of GPs, community nurses and specialist palliative care nurses who gives this support to patients in their own homes. We want to know how these professionals perceive their roles and how this may have changed during and after the pandemic. We also want to know what helps and hinders joint working between these professionals. This will help us understand how to improve co-ordination of care amongst these professionals in the current climate. This study is taking place across two Integrated Care Systems in South West England – Bristol, North Somerset and South Gloucestershire and Bath, Swindon and Wiltshire.

We have already gathered valuable insights from the community nursing and specialist palliative care teams. We now want to hear from GPs to complete the picture on this important topic. If you would like to share your views or would like more information, please get in touch by emailing tanuka.palit@bristol.ac.uk

For more about Palliative and End of Life Care Research at the University of Bristol, see the Palliative and End of Life Care Research Group.

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