The challenges and experiences of providing end-of-life care in primary care: online survey and semi-structured interviews with UK primary care professionals.

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Primary care professionals deliver the majority of end-of-life care to patients. However, extensive pressures and constraints can contribute to variable and substandard care quality. We will report on the preliminary results from an independent evaluation of the 'Daffodil Standards for Advanced Serious Illness and End-of-Life Care', created by the Royal College of General Practitioners and Marie Curie. To map activities to improve end-of-life care undertaken by GP practices, including the implementation of the Daffodil Standards. An online survey (Phase 1) has been made available to all GP practices in the UK to capture end-of-life care activities, experiences and challenges. Those who have signed up to receive guidance about the Daffodil Standards are also asked about their experiences of implementation and impact. Alongside this, a sub-sample of the survey responders are invited to take part in a semi-structured interview (n=20-26) to identify processes and mechanisms of implementation (Phase 2). This project is informed by the Normalisation Process Theory (NPT). Descriptive statistics (survey) and Framework Analysis (survey, interviews) are used to analyse the data. Sixty-eight surveys, of which 41% (n=28/68) had signed up to the Daffodil Standards, and five semi-structured interviews have been completed to date. Recruitment to both the survey and interviews is ongoing. The preliminary results of Phases 1 and 2 will be available for presentation in March 2023. The results will be used to inform and refine the design illustrative case studies to capture best available learning and identify exemplars of best practice for later phases of the study.