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Building bridges in palliative care: evaluating a GP facilitator programme

Building bridges in palliative care: evaluating a GP facilitator programme
Building bridges in palliative care: evaluating a GP facilitator programme
The objective of this study was to evaluate the impact of the Macmillan GP Facilitator Programme in Palliative Care on the knowledge, attitudes and confidence in symptom control of general practitioners (GPs), communication with patients and out-of-hours practice. GP Facilitators work on average for two sessions a week with practices in their locality. The design included a before and after study, with geographical controls matched on type of area (inner city, urban and rural) and broadly on Jarman scores using postal questionnaires sent to GPs. Scores measured change in GP awareness, attitudes and practice over two years of the intervention, derived from Likert scale responses to the postal questionnaires. Although overall few significant results were found, we did identify an increase in the use of palliative care guidelines in Facilitator districts, together with an increase in awareness of day care. The programme was associated with increased positive attitudes towards specialist palliative care services and results suggested increased satisfaction with out-of-hours services for patients. No change was found for confidence in symptom control and communication over diagnosis with cancer patients was less than in control districts. The design also incorporated a qualitative component, and from this we found the Facilitator programme to be popular with local GPs who valued the support of a colleague who knew the demands and constraints of general practice. In conclusion, we have demonstrated an impact of the GP Facilitator programme on GP awareness of, use and increased positive attitudes towards specialist palliative care services. By improving communication between primary and specialist palliative care, the programme should contribute substantially to improved care of the dying at home.
FACILITATOR, GENERAL PRACTICE, PALLIATIVE CARE, PEER EDUCATION, PRIMARY CARE
0269-2163
621-627
Shipman, C.
e4158446-ccdc-4729-a199-9758f34f92bd
Addington-Hall, J.M.
87560cc4-7562-4f9b-b908-81f3b603fdd8
Thompson, M.
9678cbee-9f4e-4eba-97d7-a8f573ff4901
Pearce, A.
6ccd5735-7e67-4e6c-95bb-1ba1419937dc
Barclay, S.
980487fd-d6a7-4619-b5b7-a3853ae53908
Cox, I.
9bc03a68-1ca1-43bb-bc21-f9ffc6efa7c7
Maher, J.
0cf75728-32e0-4052-b21c-093623f95407
Millar, D.
98ad0cc9-7524-4694-8db2-77fb49f12416
Shipman, C.
e4158446-ccdc-4729-a199-9758f34f92bd
Addington-Hall, J.M.
87560cc4-7562-4f9b-b908-81f3b603fdd8
Thompson, M.
9678cbee-9f4e-4eba-97d7-a8f573ff4901
Pearce, A.
6ccd5735-7e67-4e6c-95bb-1ba1419937dc
Barclay, S.
980487fd-d6a7-4619-b5b7-a3853ae53908
Cox, I.
9bc03a68-1ca1-43bb-bc21-f9ffc6efa7c7
Maher, J.
0cf75728-32e0-4052-b21c-093623f95407
Millar, D.
98ad0cc9-7524-4694-8db2-77fb49f12416

Shipman, C., Addington-Hall, J.M., Thompson, M., Pearce, A., Barclay, S., Cox, I., Maher, J. and Millar, D. (2003) Building bridges in palliative care: evaluating a GP facilitator programme. Palliative Medicine, 17 (7), 621-627. (doi:10.1191/0269216303pm809oa).

Record type: Article

Abstract

The objective of this study was to evaluate the impact of the Macmillan GP Facilitator Programme in Palliative Care on the knowledge, attitudes and confidence in symptom control of general practitioners (GPs), communication with patients and out-of-hours practice. GP Facilitators work on average for two sessions a week with practices in their locality. The design included a before and after study, with geographical controls matched on type of area (inner city, urban and rural) and broadly on Jarman scores using postal questionnaires sent to GPs. Scores measured change in GP awareness, attitudes and practice over two years of the intervention, derived from Likert scale responses to the postal questionnaires. Although overall few significant results were found, we did identify an increase in the use of palliative care guidelines in Facilitator districts, together with an increase in awareness of day care. The programme was associated with increased positive attitudes towards specialist palliative care services and results suggested increased satisfaction with out-of-hours services for patients. No change was found for confidence in symptom control and communication over diagnosis with cancer patients was less than in control districts. The design also incorporated a qualitative component, and from this we found the Facilitator programme to be popular with local GPs who valued the support of a colleague who knew the demands and constraints of general practice. In conclusion, we have demonstrated an impact of the GP Facilitator programme on GP awareness of, use and increased positive attitudes towards specialist palliative care services. By improving communication between primary and specialist palliative care, the programme should contribute substantially to improved care of the dying at home.

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More information

Published date: 2003
Keywords: FACILITATOR, GENERAL PRACTICE, PALLIATIVE CARE, PEER EDUCATION, PRIMARY CARE

Identifiers

Local EPrints ID: 11134
URI: http://eprints.soton.ac.uk/id/eprint/11134
ISSN: 0269-2163
PURE UUID: 1f6550ca-ccf5-425b-a2f4-401902a862ed

Catalogue record

Date deposited: 28 Oct 2004
Last modified: 15 Mar 2024 05:02

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Contributors

Author: C. Shipman
Author: M. Thompson
Author: A. Pearce
Author: S. Barclay
Author: I. Cox
Author: J. Maher
Author: D. Millar

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