GPs: ‘Allow us more time with the terminally ill’

Overstretched GPs call for more time to meet the needs of their terminally ill patients

Marie Curie and RCGP call for UK-wide Commission to recommend how primary care can meet growing end of life care challenges

The majority of GPs do not have the time they would like to support their patients with a terminal illness, according to a new UK-wide survey from the Royal College of General Practitioners (RCGP) and Marie Curie.

83% of GPs listed giving more time to terminally ill patients as a top priority for general practice in terms of improving end of life care, but many said that they lacked the time and resource to deliver this.

GPs said that they would ideally like more time than they currently have with patients and families, and particularly for those who are able to visit their surgeries.

While the majority of GPs (71%) thought that over 20 minutes should ideally be allocated to consultations with terminally ill patient at the practice, 86% said their routine appointment time was 20 minutes or less and nearly half (46%) were only able to offer 10 minutes or less.

On average GPs spent longer on home visits but while a third (33%) said they would ideally like to spend more than 40 minutes with patients,only 14% were able to.

One of the GPs surveyed said:

“Special provision needs to be made for this group of patients – they need more time and a flexible proactive approach. At the moment they are just squeezed in amongst all the acute care and paperwork in an already full day. It is impossible to give the best possible care in these conditions and can be very frustrating for everyone.”

The survey, which involved 184 GP practices across the UK, also highlighted the need for more education and training for practice staff and issues with the availability of support from community care services.

In response to the results of the survey, Marie Curie and the RCGP have called for a UK-wide Commission to develop recommendations on how primary care will ensure that GPs and their practices have the time and resources to provide high quality end of life care.

Professor Maureen Barker, Chair of the RCGP, said:

“The unique role of a GP means that we care for patients from the beginning to the end of their lives, and caring for our terminally ill patients is one of the most challenging yet rewarding parts of our job.

“But caring for patients at or nearing the end of their lives requires time, and with the current resource and workforce pressures facing general practice, its unsurprising that so many of our members don’t feel they have enough time to do this most effectively.

“With the number of terminally ill people who will need the support of their GP team only set to increase, this is an issue that needs to be tackled now. We therefore strongly support Marie Curie’s call for a UK-wide Commission to look at the resources GP practices need in order to deliver excellent care.”

Dr Catherine Millington-Sanders, a practising GP and RCGP / Marie Curie National End of Life Care Clinical Champion, said:

“People with a terminal illness require a great deal of support throughout their illness and GPs, together with the wider community care teams, provide most of the medical care for the increasing number of people choosing to die at home. But with GPs and community care services under increasing pressure, we urgently need to consider how we can continue to provide appropriate care to the growing number of people who need our care and support.

“Having limited time with terminally ill patients’ means we are less able to provide continuity of care, have sensitive care planning discussions and make arrangements that will improve the patient’s quality of life. Families will also miss out on vital information and practical support they will need as their loved one’s condition deteriorates.”

Simon Jones, Director of Policy and Public Affairs for Marie Curie, said:

“The unprecedented demand for primary care services is one of the biggest issues facing our healthcare system today and has specific consequences for those who are nearing the end of their lives. Indeed, carers tell us that seven out of 10 people with a terminal illness don’t get all the care and support they need.

“If we are to avoid an all-out crisis, it is essential that the Government make this an area of priority and establish a UK-wide Commission to ensure that we understand the level of resources that are needed for GP practices to able to provide the holistic care that people being cared for in their communities, so desperately require.”