End-of-life care in the community during the first peak of COVID-19: what were the views and experiences of primary healthcare professionals?

Conference:

SAPC ASM 2021 - virtual

Talk Code:

P1.18.3

Presenter:

Sarah Mitchell

Twitter:

@MacGPSarah

Co-authors:

Phillip Oliver, Clare Gardiner, Helen Chapman, Dena Khan (PPI co-author), Kirsty Boyd, Jeremy Dale, Stephen Barclay, Catriona Mayland

Author institutions:

University of Sheffield, Sheffield Teaching Hospitals, NIHR CRN West Midlands Young People's Steering Group, University of Edinburgh, University of Warwick, University of Cambridge

Problem

Thousands of people in the UK have required end-of-life care in the community during the COVID-19 pandemic. Primary healthcare teams (general practice and community nursing services) have provided the majority of this care, alongside specialist colleagues. There is a striking lack of research in this area from previous pandemics. This study aims to provide learning from experiences in primary care during COVID-19 in order to inform future service delivery and planning.

Approach

A web-based, UK-wide questionnaire survey circulated via general practice and community nursing professional networks during September and October 2020. Responses were analysed using descriptive statistics and an inductive thematic analysis.

Findings

Valid responses were received from 559 individuals (387 community nurses, 156 General Practitioners (GPs) and 16 unspecified role), from a diverse range of regions across the UK. The vast majority of respondents reported increased involvement in providing end-of-life care in the community during the pandemic, due to both COVID-19 and non-COVID-19 conditions.

Contrasting and potentially conflicting roles emerged between general practitioners and community nurses in their response to growing demands and complexity of end-of-life care during the first phase of the COVID-19 pandemic. Community nurses took greater responsibility in most aspects of palliative care practice. Use of virtual consultations by general practitioners resulted in community nurses feeling isolated, and for some there has been considerable emotional distress.

Consequences

Primary healthcare services played a critical role in meeting increased need for end-of-life care during the first phase of the COVID-19 pandemic, and continue to do so. They have adapted rapidly, but the significant emotional impact, especially for community nurses, needs addressing alongside rebuilding trusting and supportive team dynamics.

Submitted by:

Sarah Mitchell

Funding acknowledgement:

The authors received no financial support for the research, authorship and / or publication of this article. Dr Sarah Mitchell and Dr Catriona Mayland are funded by Yorkshire Cancer Research Connects Senior Research Fellowships.