Abstract

Background: The need for end-of-life care in the community increased significantly during the COVID-19 pandemic. Primary care services, including general practitioners and community nurses, had a critical role in providing such care, rapidly changing their working practices to meet demand. Little is known about primary care responses to a major change in place of care towards the end of life, or the implications for future end-of-life care services.
Aim: To gather general practitioner and community nurse perspectives on factors that facilitated community end-of-life care during the COVID-19 pandemic, and to use this to develop recommendations to improve future delivery of end-of-life care.
Design: Qualitative interview study with thematic analysis, followed by refinement of themes and recommendations in consultation with an expert advisory group.
Participants: General practitioners (n=8) and community nurses (n=17) working in primary care in the UK.
Results: General practitioner and community nurse perspectives on factors critical to sustaining community end-of-life care were identified under three themes: (1) partnership working is key, (2) care planning for end-of-life needs improvement, and (3) importance of the physical presence of primary care professionals. Drawing on participants’ experiences and behaviour change theory, recommendations are proposed to improve end-of-life care in primary care.
Conclusions: To sustain and embed positive change, an increased policy focus on primary care in end-of-life care is required. Targeted interventions developed during COVID-19, including online team meetings and education, new prescribing systems and unified guidance, could increase capacity and capability of the primary care workforce to deliver community end-of-life care.

Cite as

Turner, N., Wahid, A., Oliver, P., Gardiner, C., Chapman, H., Khan, D., Boyd, K., Dale, J., Barclay, S., Mayland, C. & Mitchell, S. 2022, 'Role and response of primary healthcare services in community end-of-life care during COVID-19:Qualitative study and recommendations for primary palliative care delivery', Palliative Medicine. https://doi.org/10.1177/02692163221140435

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Last updated: 12 December 2022
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