Abstract
BackgroundOut-of-hours GP care in England, Denmark and the Netherlands has been reorganised and is now provided by large scale GP co-operatives. Adequate transfer of information is necessary in order to assure continuity of care, which is of major importance in palliative care. We conducted a study to assess the availability, content and effect of information transferred to the GP co-operatives.MethodsCross-sectional exploratory study of all palliative care phone calls during a period of one year to a GP co-operative.ResultsThe total number of phone calls about patients who needed palliative care was 0.75% of all calls to the GP co-operative. Information was transferred by GPs on 25.5% of palliative care patient calls, and on 12% of palliative care patient calls from residential care homes. For terminally ill patients the number of information transfers increased to 28.9%. When information was transferred, the content consisted mainly of clinical data. Information about the diagnosis and current problems was transferred in more than 90% of cases, information about the patient's wishes in 45% and information about the patient's psychosocial situation in 30.5% of cases.A home visit was made after 53% of the palliative care calls.When information was transferred, fewer patients were referred to a hospital.ConclusionGPs frequently fail to transfer information about their palliative care patients to the GP co-operatives. Locums working at the GP co-operative are thus required to provide palliative care in complex situations without receiving adequate informationGPs should be encouraged and trained to make this information available to the GP co-operatives.
Highlights
Out-of-hours general practitioners (GPs) care in England, Denmark and the Netherlands has been reorganised and is provided by large scale GP co-operatives
Locums working at the GP co-operative are required to provide palliative care in complex situations without receiving adequate information
Information on 141 patients receiving palliative care was transferred to the GP co-operative (25.5%). (Additional file 1: Table S1) The incidence of information transfer did not differ according to the various underlying diseases, gender or age-groups, with the exception of the group of patients over 90 years of age, for 10.5% of whom information was transferred
Summary
Out-of-hours GP care in England, Denmark and the Netherlands has been reorganised and is provided by large scale GP co-operatives. Dutch general practitioners (GPs) consider palliative care as an essential part of family medicine. In their opinion, providing care at home for dying patients is an important aspect of achieving their goal of "comprehensive, continuous and personal care" for these patients. Until 2000, most patients received out-of-hours palliative care from their own GP, and availability for home visits and out-of-hours care was identified by both patients and GPs as a core aspect of value in palliative care [2]. This availability has virtually disappeared after the recent reorganisation of out-of-hours care. Other symptoms, and social, psychological and spiritual problems is paramount [4]
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