No longer an optional extra

Many general practitioners shy away from palliative care. They feel uncomfortable about working in teams, know little about controlling symptoms, and are reluctant to use powerful drugs in effective doses. Furthermore, some worry about demands on their time and are afraid to expose themselves to painful emotions.

A recent review of current standards of palliative care in general practice by the Royal College of General Practitioners identified deficits and tested a range of remedial measures.1 Facilitators (one from each of five faculties of the college) were selected for their experience in palliative care, postgraduate education, and, by inference, audit. Together these skills represent those available in an ideal general practice; providing them has substantial implications …