Marie Curie survey reveals GP concerns over end of life care

Less than half of GPs feel the majority of their terminally ill patients’ pain is relieved completely, a survey by cancer charity Marie Curie has revealed.

A third of GPs said they did not believe their terminally ill patients get adequate access to specialist palliative care nursing and the majority highlighted the weekend and evenings as times where patients might not receive adequate access to care.

The survey of 1,000 GPs has been published at the same time as the charities report ‘Difficult Conversations with dying people and their families,’ which explores the experiences and changing needs over time of a terminally ill person and their family.

A good death

The report described that although the idea of ‘a good death’ is frequently used in policy documents, it was a relatively unknown term to patients, even though most had an implicit awareness of what they felt a ‘good death’ meant.

Key components for a ‘good death’ included a calm, private environment with access to pain relief administered by experts, whereas being alone or in hospital was associated with a ‘bad death.’

Dr Bill Noble, medical director of Marie Curie said: “GPs are best placed to ensure effective co-ordination of palliative care. If their patients are to get the care they need to be at home in their terminal illness, NHS, social services and voluntary sector professionals all have their part to play.

“Our ageing population has increasingly complex and diverse needs, so it’s important that we equip and support GPs in their work.”

Families and participants in the Marie Curie report described their experiences of end of life care, with vital drugs being hours late, having to chase after prescriptions and locums unable to provide prescriptions, which Marie Curie wants to prevent happening in the future.

Imelda Redmond, director of policy & public affairs at Marie Curie, said: “Everyone is telling us – from GPs, families and carers – that more needs to be done to improve access to specialist palliative care and pain control at home.

Pain management

“We know that effective pain management at home is an important factor that influences whether someone has a 'good death', and we only have one chance to get it right.

“Terminally ill people and their families need timely access to care and pain relief around the clock. At the moment two thirds of this time is considered to be ‘out of hours’ by the healthcare system.

“Terminally ill people should not be spending their last precious weeks and days with the families in unnecessary pain because the system moves too slowly.”

Participants in the report described a need for clearer guidance and a simpler system offering contact to the same professionals to help a terminally ill patient receive better care.

The report has called for more work to be done to help people understand and plan for changes that occur during the process of death, and to simplify the current complex health and social care system to put people and their needs at the centre of services.