• Nicola Turner, Aysha Wahid, Phillip Oliver, Clare Gardiner, Helen Chapman, Dena Khan Ppi Co-Author, Kirsty Boyd, Jeremy Dale, Stephen Barclay, Catriona R Mayland, and Sarah J Mitchell.
• University of Sheffield, Sheffield, UK.
• Palliat Med. 2023 Feb 1; 37 (2): 235243235-243.

BackgroundThe need for end-of-life care in the community increased significantly during the COVID-19 pandemic. Primary care services, including general practitioners and community nurses, had a critical role in providing such care, rapidly changing their working practices to meet demand. Little is known about primary care responses to a major change in place of care towards the end of life, or the implications for future end-of-life care services.AimTo gather general practitioner and community nurse perspectives on factors that facilitated community end-of-life care during the COVID-19 pandemic, and to use this to develop recommendations to improve future delivery of end-of-life care.DesignQualitative interview study with thematic analysis, followed by refinement of themes and recommendations in consultation with an expert advisory group.ParticipantsGeneral practitioners (n = 8) and community nurses (n = 17) working in primary care in the UK.ResultsGeneral practitioner and community nurse perspectives on factors critical to sustaining community end-of-life care were identified under three themes: (1) partnership working is key, (2) care planning for end-of-life needs improvement, and (3) importance of the physical presence of primary care professionals. Drawing on participants' experiences and behaviour change theory, recommendations are proposed to improve end-of-life care in primary care.ConclusionsTo sustain and embed positive change, an increased policy focus on primary care in end-of-life care is required. Targeted interventions developed during COVID-19, including online team meetings and education, new prescribing systems and unified guidance, could increase capacity and capability of the primary care workforce to deliver community end-of-life care.

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