Palliative care services in the community: what do family doctors want?

The views of family doctors on local specialist palliative care services such as hospices and home care teams and the needs of their patients were studied. Of 203 family doctors sent a questionnaire, 102 (50%) responded. Attempts were made to follow up a random sample of 42 non-responders by telephone interview. During the previous two years family doctors had referred a mean of 5.5 patients to inpatient specialist palliative care services. A further 4.7 patients had been referred to specialist palliative home care teams. During the same two years family doctors had cared for a mean of 2 patients during the terminal phase of illness without input from specialist palliative care services. Although many reports about the services were favorable, family doctors wished for improved communication and liaison from palliative care services, input for patients who did not have cancer, and improved out-of-hours access. The telephone survey of non-responders suggested that these doctors had lower levels of awareness of palliative care problems and services. The findings support the move by specialist palliative care services to extend their remit beyond cancer and to provide 24-hour care. They also signal a need for caution if primary care is to determine the development of palliative care.