According to the Dying Matters Coalition, around 1% of a GP’s patients will die in any given year. The new three-year partnership between Marie Curie and the RCGPs aims to improve the care that these patients receive from their GP.
The new programme of work is likely to include the development of new clinical guidelines for GPs and primary care teams, online toolkits and support, the promotion of training, identifying and promoting best practice and influencing and supporting clinical commissioning groups in end of life care planning.
Two of the priorities of the programme will be advanced care planning and patient choice of place of death. Nearly everyone has a GP and, as well as caring for their patients at the end of life, research from Dying Matters shows that people are four times more likely to want to talk to their GP about planning for their end of life than to a solicitor, and 10 times more likely than to a nurse.
GPs are also the gate-keepers to health services in England, due to the recent changes in how healthcare services are commissioned, and so play a key role in planning support for dying people and enabling them to achieve the death they would like. As well as commissioning issues, the partnership will also look at health inequalities – research has shown that there are great variations in access to, and quality of, end of life care, depending on location and diagnosis.
Pain management will also be a priority – last month the National Bereavement Survey highlighted that only 19% of those who were at home at the end of life experienced complete pain relief, all of the time.
As part of the partnership, Dr Peter Nightingale has been appointed clinical lead for end of life care. Dr Nightingale is a practicing GP and also works with St John’s Hospice in Lancaster. He has also been involved in Dying Matter’s GP training project, which aims to boost GPs’ confidence in end of life conversations.
Working part-time with the RCGP and Marie Curie, Dr Nightingale will lead the programme of work that will improve primary care provision for patients nearing the end of their life, including vulnerable patients such as those with dementia and learning disabilities.
Dr Adam Firth, a GP in Stockport, has also been appointed as RCGP clinical support fellow for end of life care to work alongside Dr Nightingale. He said: “It is a real privilege to be appointed as the RCGP clinical support fellow for end of life care. The chance to help shape policy, training and ultimately the clinical care that patients receive at the end of life is something I relish and I am particularly passionate about ensuring those with non-cancer diagnoses receive high quality palliative care services co-ordinated and largely delivered by primary care teams.”
Imelda Redmond, director of policy and public affairs at Marie Curie, said: “Given the choice, most of us would want to die at home surrounded by the people and things we cherish, but this does not always happen. GPs play an essential role in caring for patients at the end of their lives – especially those who are cared for at home.
“We want to improve end of life care for all patients and that means working effectively with GPs. One of the most exciting things about this project is that it will cut across several other major themes which the Royal College already focuses on – including dementia, cancer, rare diseases and COPD. We see this partnership as a defining moment in improving end of life care and helping GPs to deliver the best possible support to people with end of life needs.”