Sarah Mitchell1, Phillip Oliver2, Clare Gardiner3, Helen Chapman4, Dena Khan5, Kirsty Boyd6, Jeremy Dale7, Stephen Barclay8, Catriona R Mayland9. 1. Yorkshire Cancer Research Senior Research Fellow, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK s.j.mitchell@sheffield.ac.uk. 2. Clinical Lecturer, Academic Unit of Medical Education, University of Sheffield, Sheffield, UK. 3. Senior Research Fellow, Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK. 4. Queen's Nurse and Head of Integrated Community Care, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. 5. Patient and Public Involvement Representative, University of Warwick, Warwick, UK. 6. Reader in Palliative Care, Usher Institute, University of Edinburgh, Edinburgh, UK. 7. Professor of Primary Care, Warwick Medical School, University of Warwick, Coventry, UK. 8. Senior Lecturer in General Practice and Palliative Care, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. 9. Yorkshire Cancer Research Senior Research Fellow, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
Abstract
BACKGROUND: Thousands of people in the UK have required end-of-life care in the community during the COVID-19 pandemic. Primary healthcare teams (general practice and community nursing services) have provided the majority of this care, alongside specialist colleagues. There is a need to learn from this experience in order to inform future service delivery and planning. AIM: To understand the views of GPs and community nurses providing end-of-life care during the first wave of the COVID-19 pandemic. DESIGN & SETTING: A web-based, UK-wide questionnaire survey circulated via professional general practice and community nursing networks, during September and October 2020. METHOD: Responses were analysed using descriptive statistics and an inductive thematic analysis. RESULTS: Valid responses were received from 559 individuals (387 community nurses, 156 GPs, and 16 unspecified roles), from all regions of the UK. The majority reported increased involvement in providing community end-of-life care. Contrasting and potentially conflicting roles emerged between GPs and community nurses. There was increased use of remote consultations, particularly by GPs. Community nurses took greater responsibility in most aspects of end-of-life care practice, particularly face-to-face care, but reported feeling isolated. For some GPs and community nurses, there has been considerable emotional distress. CONCLUSION: Primary healthcare services are playing a critical role in meeting increased need for end-of-life care in the community during the COVID-19 pandemic. They have adapted rapidly, but the significant emotional impact, especially for community nurses, needs addressing alongside rebuilding trusting and supportive team dynamics.
BACKGROUND: Thousands of people in the UK have required end-of-life care in the community during the COVID-19 pandemic. Primary healthcare teams (general practice and community nursing services) have provided the majority of this care, alongside specialist colleagues. There is a need to learn from this experience in order to inform future service delivery and planning. AIM: To understand the views of GPs and community nurses providing end-of-life care during the first wave of the COVID-19 pandemic. DESIGN & SETTING: A web-based, UK-wide questionnaire survey circulated via professional general practice and community nursing networks, during September and October 2020. METHOD: Responses were analysed using descriptive statistics and an inductive thematic analysis. RESULTS: Valid responses were received from 559 individuals (387 community nurses, 156 GPs, and 16 unspecified roles), from all regions of the UK. The majority reported increased involvement in providing community end-of-life care. Contrasting and potentially conflicting roles emerged between GPs and community nurses. There was increased use of remote consultations, particularly by GPs. Community nurses took greater responsibility in most aspects of end-of-life care practice, particularly face-to-face care, but reported feeling isolated. For some GPs and community nurses, there has been considerable emotional distress. CONCLUSION: Primary healthcare services are playing a critical role in meeting increased need for end-of-life care in the community during the COVID-19 pandemic. They have adapted rapidly, but the significant emotional impact, especially for community nurses, needs addressing alongside rebuilding trusting and supportive team dynamics.
Authors: Sean B O'Donnell; Anna E Bone; Anne M Finucane; Jenny McAleese; Irene J Higginson; Stephen Barclay; Katherine E Sleeman; Fliss Em Murtagh Journal: Palliat Med Date: 2021-08-23 Impact factor: 4.762
Authors: Lucy Ellen Selman; Djj Farnell; M Longo; S Goss; K Seddon; A Torrens-Burton; C R Mayland; D Wakefield; B Johnston; A Byrne; E Harrop Journal: Palliat Med Date: 2022-02-17 Impact factor: 4.762
Authors: Sarah Mitchell; Madeleine Harrison; Phillip Oliver; Clare Gardiner; Helen Chapman; Dena Khan; Kirsty Boyd; Jeremy Dale; Stephen Barclay; Catriona R Mayland Journal: Palliat Med Date: 2021-12-17 Impact factor: 4.762
Authors: Katherine E Sleeman; Rachel L Cripps; Fliss E M Murtagh; Adejoke O Oluyase; Mevhibe B Hocaoglu; Matthew Maddocks; Catherine Walshe; Nancy Preston; Lesley Dunleavy; Andy Bradshaw; Sabrina Bajwah; Irene J Higginson; Lorna K Fraser Journal: J Palliat Med Date: 2021-12-20 Impact factor: 2.947
Authors: Andy Bradshaw; Lesley Dunleavy; Ian Garner; Nancy Preston; Sabrina Bajwah; Rachel Cripps; Lorna K Fraser; Matthew Maddocks; Mevhibe Hocaoglu; Fliss Em Murtagh; Adejoke O Oluyase; Katherine E Sleeman; Irene J Higginson; Catherine Walshe Journal: J R Soc Med Date: 2022-02-08 Impact factor: 18.000
Authors: Catriona R Mayland; Sarah Mitchell; Kate Flemming; Lynn Tatnell; Lesley Roberts; John I MacArtney Journal: BMJ Support Palliat Care Date: 2022-06-16 Impact factor: 4.633