Intended for healthcare professionals

Rapid response to:

Opinion Primary Colour

Helen Salisbury: Holding on to what makes general practice special

BMJ 2022; 378 doi: (Published 30 August 2022) Cite this as: BMJ 2022;378:o2002

Rapid Response:

Re: Helen Salisbury: Holding on to what makes general practice special

Dear Editor
There is much end of life care can learn from obstetric care. The entry into life carries many similarities to the exit from it: the enormity of the event, the importance of the wider social group, the debate about medicalisation and many others.
Working in end of life care I have always been keen to learn from obstetric colleagues. Excluding primary care in the way that Helen Salisbury describes is not a option I would want to adopt from them.
To me it is about risk. The concept of a high risk pregnancy has been around for decades clearly indicating the need for specialist input. We should also be able to identify the high risk deaths where palliative care services should play an active role. If none of these are present then the informed and interested GP and their team should be at the forefront of supporting the patient and family as they die.
It gives me great pride that we have fifteen GP specialist trainees with us each year and twelve 2nd year foundation doctors. There is much to learn to achieve a good death so my only proviso to Dr Salisbury is that the training has to be available and well supported at all levels to produce GPs who can provide the best end of life care.

Competing interests: No competing interests

04 September 2022
Andrew Thorns
Consultant in Palliative Medicine
Pilgrims Hospices in East Ketn
Margate, Kent