GP experiences and educational needs when providing integrated palliative care

Background
The current policy context within Scotland aims to ensure every person nearing the end of life has the opportunity to access palliative care services. These services are to be primarily provided either at home, or in a homely setting, putting General Practitioners (GPs) and the wider primary care team at the forefront of delivering these policies.

Aim
Working in partnership, a GP Palliative Care Facilitator, Hospice Palliative Medicine Consultant and Quality Improvement Researcher undertook a quality improvement project to improve integrated palliative care and undertake educational updates to GPs in one locality.

Methods
Focus groups were undertaken in seven GP practices. A total of 33 GPs participated and 64% (n=21) returned completed evaluation forms following the meetings. In addition to the evaluation questionnaire and educational feedback questionnaire, notes were taken during the focus groups. Using NVIVO10 software to analyse the data, key themes were identified.

Results
Ensuring seamless care is provided to people at the end of life presents many challenges for GPs. Keeping their clinical knowledge up to date, working with others and understanding local referral pathways between care settings and services can often lead to delays. People with life limiting non-malignant disease were highlighted as being at risk of not being referred to specialist palliative care services. This was due to the difficulty in identifying when referral was appropriate.

Conclusion
Group meetings were a successful and acceptable way to update limit-limited GPs on current specialist palliative care services available, gain feedback on services, and undertake education sessions.