An article from GP magazine David Millett on the 14 January 2016
BMA leaders have urged all UK governments to prioritise end-of-life care after research by the union found current provision – although ‘excellent’ in some areas – ‘does not match expectations’ of either doctors or the public.
Communication between primary and secondary care must be overhauled to improve patients’ experiences of palliative care, the researchers found. In a series of interviews with patients and healthcare workers, they found that poor communication made it difficult to plan and co-ordinate care across healthcare sectors.
Some GPs said they had not received adequate training on how to handle the dying process with patients and felt ‘uncomfortable’ having to give uncertain answers on the timescale of life expectancy and fully meeting patients’ needs.
The study suggested that the primary care role in delivering palliative care can be ‘unclear’ in some areas, leading to inconsistencies across the country. It warned that continued provision of palliative care in the community – most patients’ preferred environment – would become much more challenging should GP workforce and workload problems worsen.
There is also a ‘generally held view’ that patients dying from cancer tend to receive better medical care than those with other conditions because of the way cancer services are organised, the study found.
BMA Scotland chairman Dr Peter Bennie said: ‘The UK has led the world in developing comprehensive and holistic care for people whose lives are coming to an end. Yet this new research provides further evidence that the provision of end-of-life care remains variable, dependent on a patient’s location, their condition, and their knowledge of local services.
‘What came through loud and clear during the study was that people want to be treated as individuals, with care and compassion, and it is very important to many people that their families are involved in the process. The current system doesn’t always enable this.
‘Doctors need the time, support and sufficient training to care for people at the end of life, and patients must be able to access the same high quality end-of-life care wherever they live, whatever their medical condition.’