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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

Turner, Nicola; Wahid, Aysha; Oliver, Phillip; Gardiner, Clare; Chapman, Helen; Khan, Dena; Boyd, Kirsty; Dale, Jeremy; Barclay, Stephen; Mayland, Catriona R.; Mitchell, Sarah J.

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 Thumbnail


Authors

Aysha Wahid

Phillip Oliver

Clare Gardiner

Helen Chapman

Dena Khan

Kirsty Boyd

Jeremy Dale

Stephen Barclay

Catriona R. Mayland

Sarah J. Mitchell



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.

Citation

Turner, N., Wahid, A., Oliver, P., Gardiner, C., Chapman, H., Khan, D., …Mitchell, S. J. (2023). 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, 37(2), 235-243. https://doi.org/10.1177/02692163221140435

Journal Article Type Article
Acceptance Date Oct 31, 2022
Online Publication Date Dec 3, 2022
Publication Date 2023-02
Deposit Date Dec 12, 2022
Publicly Available Date Jan 3, 2023
Journal Palliative Medicine
Electronic ISSN 1477-030X
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 37
Issue 2
Pages 235-243
DOI https://doi.org/10.1177/02692163221140435
Public URL https://nottingham-repository.worktribe.com/output/14602557
Publisher URL https://journals.sagepub.com/doi/10.1177/02692163221140435

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