BMJ  2005;330:671 (19 March), doi:10.1136/bmj.330.7492.671-a

Letter

Developing primary palliative care

Primary palliative care services must be better funded by both day and night

The first 150 words of the full text of this article appear below.

EDITOR—Guthrie's response to our editorial of 6 November on developing primary palliative care is helpful in pointing out that the new out of hours organisations are now responsible for three quarters of the week's on call hours, while primary care teams working during the day are responsible for only a quarter.¹ This of course means that general practitioners and district nurses working out of hours will often attend people dying at home.

Unfortunately such busy organisations are often extremely stretched to deal with the diverse out of hours workload, and hand over forms for identifying patients receiving palliative care who could deteriorate in the short term are in our experience rarely in place. Progress is being made by some practices which routinely notify NHS24 in Scotland or NHS Direct in England of such patients, as recommended, for instance, in the gold standards framework.²

We do not yet know . . . [Full text of this article]

Scott.Murray@ed.ac.uk, Primary Palliative Care Research Group, Division of Community Health Sciences: General Practice Section, University of Edinburgh, Edinburgh EH8 9DX

Primary Palliative Care Research Group, Division of Community Health Sciences: General Practice Section, University of Edinburgh, Edinburgh EH8 9DX

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