Assessing and improving out-of-hours palliative care in a deprived community: a rapid appraisal study

被引:18
|
作者
Fergus, C. J. Y. [1 ]
Chinn, D. J. [2 ]
Murray, S. A. [3 ]
机构
[1] Borders Gen Hosp, Melrose TD6 9BS, Scotland
[2] Lynebank Hosp, NHS Fife, Res & Dev Resource Ctr, Dunfermline, Fife, Scotland
[3] Univ Edinburgh, Primary Palliat Care Res Grp, St Columbas Hosp Chair Primary Palliat Care, Edinburgh, Midlothian, Scotland
关键词
Out-of-hours care; palliative care; primary care; TERMINALLY-ILL PATIENTS; QUALITATIVE RESEARCH; CANCER-PATIENTS; HEALTH NEEDS; DEATH; PLACE;
D O I
10.1177/0269216309356030
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Recent changes to out-of-hours primary care in the UK have generated concerns about care for palliative care patients. The aim of this study was to identify key challenges and improvements to out-of-hours palliative care in a mixed urban and rural deprived area. We integrated data from three sources: interviews with patients and professionals, direct observations of services, and routine statistics. Key issues in the provision of care were the importance of good communication and having information available, the unwieldy process of accessing medical care out of hours, professionals bypassing routine out-of-hours care for palliative care patients, and out-of-hours care being provided by practitioners unaware of local services. We recommend provision to out-of-hours services of an enhanced 'special note' for palliative care patients, to be completed early in the course of the illness and updated regularly. The provision for certain complex patients to bypass NHS24 should be considered if routine care is not satisfactory.
引用
收藏
页码:493 / 500
页数:8
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