Palliative care in general practice: cancer patients' and carers' experience of their GP's role

Problem

Palliative care is a core part of the work of generalists. General practitioners (GPs) are well positioned to ensure coordination and continuity of care for patients, including at the end of life. Little is known about how patients understand the role of their GP in delivering palliative care in the community.This study aims to explore patients' and carers' experience of:1. The role of the GP in providing palliative care to adult patients with cancer2. The facilitators and barriers to the GP's capacity to fulfil this perceived role

Approach

Qualitative data were obtained through semi-structured interviews with adults with cancer and palliative care needs known to an inner-city London hospice. Patients were invited to bring their carer to the interview. Thematic and discourse analysis were undertaken.

Findings

Service users identified actual and desired constituents of the GP's role in palliative care provision, such as: home visits; advance care planning; care coordination; referrals; and prescription management. Multiple facilitators and barriers to the GP's capacity to deliver palliative care were identified, including: GP availability; relational and informational continuity; proactivity and perceived competence; staffing levels and time; and communication within the doctor-patient relationship.

Consequences

Findings facilitate clearer definition of the GP's role, from the service user perspective. Continued research is crucial to influence future practice and policy development, and support a more tailored, patient-centred approach to service design and delivery of end of life care.