Intended for healthcare professionals


Primary palliative care needs urgent attention

BMJ 2019; 365 doi: (Published 18 April 2019) Cite this as: BMJ 2019;365:l1827
  1. Sarah Mitchell, general practitioner and NIHR doctoral research fellow1,
  2. Amy Tan, family physician and associate professor of family medicine2,
  3. Sebastien Moine, general practitioner and visiting fellow3 4,
  4. Jeremy Dale, professor of primary care1,
  5. Scott A Murray, professor of primary palliative care3
  1. 1Unit of Academic Primary Care, Warwick Medical School, University of Warwick, Gibbet Hill Road, Coventry CV4 7AL, UK
  2. 2Dept. of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  3. 3Primary Palliative Care Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Teviot Place, Edinburgh, UK
  4. 4Health Education and Practices Laboratory, University of Paris 13, Bobigny, France
  1. Correspondence to: S Mitchell sarah.j.mitchell{at}

Primary care teams are vital to the initiation and delivery of effective palliative care

Growing numbers of people, both old and young, have complex chronic conditions and multimorbidity. Their disease trajectories are highly unpredictable; sudden health deteriorations, and the possibility of dying, are a constant risk for many. This presents huge challenges for primary and community healthcare services. Patients and families often turn to emergency healthcare services at times of acute crisis, which can lead to emergency admission to hospital. In the United Kingdom, up to one third of hospital inpatients are in their last year of life.1

Palliative care improves the quality of life of people with serious illnesses, or life threatening conditions, or both, by assessment and management of their physical, psychological, social, and spiritual needs. Substantial inequalities exist in provision, however, and patients with multimorbidity, non-malignant disease, or dementia are less likely to receive such …

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