Abstract

Care in the community has become a central feature of government policy for health and social care in the, 1990s. Reflecting this there is now widespread interest in the provision of palliative care services in community and domiciliary settings. In, 1995 Macmillan Cancer Relief embarked on a programme of development projects concerned to provide support in the home to patients who have palliative care needs, together with their informal carers. The key workers in the schemes are specially trained health care assistants, known as Macmillan Carers. An evaluation of the English schemes has been conducted and this paper draws on one distinct element of the study. Based on interviews with 37 Macmillan Carers, the paper highlights a number of key issues: first, the role of the qualified and unqualified nurse; second, the implications of the health and social care divide for this type of service; third, wider concepts of formal and informal care

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