Pilot projects help GPs to talk about end-of-life care

A training scheme backed by the RCGP has dramatically increased the confidence of GPs in talking to patients about death and dying, and in turn improved end-of-life care.

GPs can find it difficult to discuss death with their patients (Photograph: SPL)
GPs can find it difficult to discuss death with their patients (Photograph: SPL)
Pilot projects organised by the Dying Matters Coalition involved 113 GPs across 76 practices undertaking communication skills training.

At the beginning, 45% of GPs rated themselves as ‘not’ or ‘not very’ confident in having conversations with patients about death and dying.

By the end of the pilot, 94% rated themselves ‘confident’ or ‘very confident’, and the researchers found that nine out of 10 times, the patient continued the conversation that the GP had started.

Now the coalition is launching a training DVD and a series of workshops, supported by the RCGP and National End of Life Care Programme, to help more GPs change their approach.

Chairman of the coalition Professor Mayur Lakhani, a Leicestershire GP and chairman of the National Council for Palliative Care, said the average GP would be involved in 20 patient deaths per year.

‘The problem is that death is one of the last great taboos in society, and both patients and GPs find it difficult to start the conversation. But achieving a good death at home requires us to talk openly about end-of-life care.’

Lancaster GP Dr Peter Nightingale took part in the training project and saw clear benefits for his patients.

‘We have to get these early conversations with patients into the culture of general practice, and work better with secondary care to decide when there is no more that can be done for a patient.

‘We GPs have the skills to do it. We just need the confidence to start talking.’

The training DVD, called How long have I got, Doc?, is based on real-life scenarios and will be available in March 2012 from www.dyingmatters.org

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