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Named GP for people dying in the community

GPs should give dying patients their phone number for OOH emergencies

Louise Prime

Tuesday, 16 July 2013

A named GP should take overall responsibility for a patient who is dying in the community, the team behind the Liverpool Care Pathway review has recommended. They say that it is “particularly good practice” to give dying patients a telephone number on which they can reach their GP if there is an out-of-hours emergency.

The review authors also said that the patient’s GP should be involved in discussing their care plan if they have no family or carers.

The review praised the close involvement of some GPs in caring for their patients before death, which had been welcomed by their relatives. It said: “Some families spoke about the reassurance they had when a GP told them that they were taking clinical responsibility for the care of a dying patient. In some cases they told us that GPs had provided a telephone number so that they could be reached out of hours in the event of an emergency.”

They said: “The Review panel saw this as an example of particularly good practice, and recommends that a named consultant or GP should respectively take overall responsibility for the care of patients who are dying in hospital or the community.”

They reviewers went on to suggest that poor GP cover for nursing homes could be a factor in dying patients being admitted to hospital as an emergency, when they would rather have died at home. They anticipate that in future, the balance of the healthcare team looking after someone dying in the community, in particular, could change. They said: “The district nurse is likely to have a key role in coordinating care, in consultation with the GP and the palliative care team”. They said that a nurse with the appropriate training and competencies could take on the role of responsible clinician – as long as a medical practitioner remains available.

The reviewers pointed out that many patients and their families feel as though they have lost control over what is happening to them towards the end of life. They underlined the importance of properly involving patients and their relatives in developing an end-of-life plan, so that they feel it has been made in consultation with them, rather than being imposed on them. They add: “Where a patient has no relatives or carers and so is unrepresented, the discussion about the care plan needs instead to involve a GP from their registered practice.”

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