Developing primary palliative care

BMJ 2004; 329 doi: 10.1136/bmj.329.7474.1056 (Published 4 November 2004)
Cite this as: BMJ 2004;329:1056

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  1. Scott A Murray (Scott.Murray@ed.ac.uk), clinical reader,
  2. Kirsty Boyd, honorary senior lecturer,
  3. Aziz Sheikh, professor of primary care research and development,
  4. Keri Thomas, national clinical lead palliative care,
  5. Irene J Higginson, professor
  1. Primary Palliative Care Research Group, Division of Community Health Sciences: General Practice Section, University of Edinburgh EH8 9DX
  2. Primary Palliative Care Research Group, Division of Community Health Sciences: General Practice Section, University of Edinburgh EH8 9DX
  3. Cancer Services Collaborative, Birmingham, B24 0DE
  4. Department of Palliative Care and Policy, King's College, London SE5 9RJ

    People with terminal conditions should be able to die at home with dignity

    Although 65% of people with cancer want to die at home, only about 30% are successful in doing so.1 2 A government committed to choice for patients must improve this figure.3 Developing palliative care services in primary care is essential for realising the expectations of dying people. Such services could also offer important opportunities for extending supportive humane care at an earlier stage, and to people not only with cancer but with chronic obstructive pulmonary disease, motor neurone disease, and cardiac failure, for example, who also often have palliative care needs.

    Primary care professionals have the potential and ability to provide end of life care for most patients, given adequate training, resources, and, when needed, specialist advice.4 5 They share common values with palliative care specialists—holistic, patient centred care, delivered in the context of families and friends.6 However, until recently, apart from Macmillan general practitioners and nurse …

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