Mahmood-Yousuf, Kashifa, Munday, Dan, King, Nigel and Dale, Jeremy, 1958-. (2008) Interprofessional relationships and communication in primary palliative care : impact of the Gold Standards Framework. British Journal of General Practice, Vol.58 (No.549). pp. 256-263. ISSN 0960-1643

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Abstract

Background High quality end-of-life care in the community is achieved with effective multidisciplinary teamwork, interprofessional communication between GPs and district nurses, and early referral of patients to district nurses. These aspects of palliative care are highlighted in the Gold Standards Framework, a programme recently established in UK primary care. Aim To investigate the extent to which the framework influences interprofessional relationships and communication, and to compare GPs' and nurses experiences. Design of study Qualitative interview case study. Setting Fifteen participating practices from three primary care trusts in England. Method Thirty-eight semi-structured interviews were undertaken with GPs, district nurses, Macmillan nurses, and framework facilitators. Results Adoption of the framework often resulted in earlier referral of palliative care patients to district nurses. Multidisciplinary team meetings enabled communication for sharing knowledge, discussing management problems, and keeping colleagues informed; however, arranging and maintaining such meetings was often problematic. Nurses particularly valued formal meetings while GPs generally preferred informal ad hoc dialogue. GPs largely maintained control of the mode of multidisciplinary working. The best functioning teams used a mixture of formal and informal, meetings with a relatively non-hierarchical working style. Conclusion Implementing the framework enabled processes of communication associated with high quality palliative care in general practice, but there was marked variation in how this worked in individual teams. In general, hierarchical doctor-nurse relationships persisted.

Item Type:	Journal Article
Subjects:	R Medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Palliative treatment, Primary care (Medicine), Interprofessional relations, Health care teams, Terminal care
Journal or Publication Title:	British Journal of General Practice
Publisher:	Royal College of General Practitioners
ISSN:	0960-1643
Date:	April 2008
Volume:	Vol.58
Number:	No.549
Number of Pages:	8
Page Range:	pp. 256-263
Identification Number:	10.3399/bjgp08X279760
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Macmillan Cancer Support (Great Britain)
URI:	http://wrap.warwick.ac.uk/id/eprint/29960

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