Service change and innovation in community end-of-life care during the COVID-19 pandemic: qualitative analysis of a nationwide primary care survey

Sarah Mitchell*, Madeleine Harrison, Phillip Oliver, Claire Gardner, Helen Chapman, Dena Khan, Kirsty Boyd, Jeremy Dale, Stephen Barclay, Catriona Mayland

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background

Primary healthcare teams (general practice and community nursing services) within the United Kingdom provided the majority of community end-of-life care during COVID-19, alongside specialist palliative care services. As international healthcare systems move to a period of restoration following the first phases of the pandemic, the impact of rapidly-implemented service changes and innovations across primary and specialist palliative care services must be understood.

Aim

To provide detailed insights and understanding into service changes and innovation that occurred in UK primary care to deliver end-of-life care during the first phase of the COVID-19 pandemic.

Design

Cross-sectional online survey. Responses were analysed using descriptive statistics and thematic analysis.

Setting / Participants

United Kingdom survey of general practitioners and community nurses, circulated via regional and national professional networks.

Results

A total of 559 valid responses were received from 387 community nurses, 156 general practitioners and 16 “other”. Over a third of respondents (n=224; 40.8%) experienced changes in the organisation of their team in order to provide end-of-life care in response to the COVID-19 pandemic. Three qualitative themes were identified: COVID-19 as a catalyst for change in primary palliative care; new opportunities for more responsive and technological ways of working; and pandemic factors that improved and strengthened interprofessional collaboration.

Conclusion

Opportunity has arisen to incorporate cross-boundary service changes and innovations, implemented rapidly at the time of crisis, into future service delivery. Future research should focus on which service changes and innovations provide the most benefits, who for, and how, within the context of increased patient need and complexity.
Original languageEnglish
Pages (from-to)161-170
JournalPalliative Medicine
Volume36
Issue number1
Early online date17 Dec 2021
DOIs
Publication statusPublished - 1 Jan 2022

Keywords

  • Primary health care
  • General practice
  • Primary care nursing
  • Palliative care
  • end-of-life care
  • COVID-19

Fingerprint

Dive into the research topics of 'Service change and innovation in community end-of-life care during the COVID-19 pandemic: qualitative analysis of a nationwide primary care survey'. Together they form a unique fingerprint.

Cite this