Out-of-hours Services For Palliative Care Need To Be Appropriately Integrated And Resourced

Main Category: Palliative Care / Hospice Care
Article Date: 27 Dec 2005 - 0:00 PDT

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Effective out-of-hours community palliative care requires an integrated, multidisciplinary service able to respond to planned and acute needs, a study in the January 2006 issue of the British Journal of General Practice (BJGP) finds.

Researchers interviewed patients, carers and professionals to explore their experiences and perceptions of out-of-hours care of patients with advanced cancer. The findings highlight the difficulties patients and carers had in deciding whether to call out-of-hours services due to anxiety about the legitimacy of need, reluctance to bother the doctor and perceptions of triage as blocking access to care. Out-of-hours was considered to be impersonal.

Positive experiences were related to effective planning, particularly transfer of information and empathic responses from staff. Professionals expressed concern about delivering good palliative care within the constraints of a generic acute service and problems accessing other health and social care services.

Dr Alison Worth, Reader in Cancer Care at the Cancer Care Research Centre, University of Stirling and lead researcher, said: "Continuity of care may be personal, informational or managerial, the latter implying a consistent and coherent approach responsive to the patient's changing needs. In the context of current primary care provision, personal continuity of care is increasingly unlikely to be provided out-of-hours, but our data suggest that informational and management continuity, supplemented by good communication, may suffice. Equitable access to a range of health and social care professionals and support staff across the UK may well demand additional resources, particularly for district nurses."

Worth A, Boyd K, Kendall M, Heaney D, Macleod U, Cormie P, Hockley J and Murray S. "Out-of-hours palliative care: a qualitative study of cancer patients, carers and professionals". BJGP January 2006; 56: 6-13.

The BJGP is published monthly and distributed to over 23,000 RCGP members, associates, and subscribers in more than 40 countries worldwide. Its primary purpose is to publish first-rate, peer reviewed research papers on topics relevant to primary care.

The Royal College of General Practitioners is the largest membership organisation in the United Kingdom solely for GPs. It aims to encourage and maintain the highest standards of general medical practice and to act as the "voice" of GPs on issues concerned with education; training; research; and clinical standards. Founded in 1952, the RCGP has over 23,000 members who are committed to improving patient care, developing their own skills and promoting general practice as a discipline.

Promoting excellence in family medicine:
http://www.rcgp.org.uk

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