JRSM > Volume 97, Number 9 > Pp. 428-431

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Community hospitals: an under-recognized resource for palliative care

Sheila Payne PhD  ¹ Chris Kerr PhD  ² Sheila Hawker PhD  ² David Seamark PhD  ³ Carol Davis FRCP  ⁴ Helen Roberts FRCP  ⁴ Nicola Jarrett PhD  ⁵ Paul Roderick FFPHM  ⁶   Helen Smith DM  ⁷

¹ Palliative and End-of-Life Care Research Group, University of Sheffield, Bartolome House, Winter Street, Sheffield S3 7ND
² Social Work Studies, University of Southampton
³ The Honiton Group Practice, Honiton, Devon
⁴ Elderly Care Research Unit, Southampton General Hospital
⁵ School of Nursing and Midwifery, University of Southampton
⁶ Health Care Research Unit, Southampton General Hospital
⁷ Division of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK

Correspondence to: Professor S Payne E-mail: s.a.payne{at}sheffield.ac.uk

In the UK there are concerns that, in certain groups of dying patients such as the old, those with non-cancer diagnoses and those in rural areas, the quality of care is unacceptably variable. There has been no systematic survey of the extent to which community hospitals provide general palliative care for such patients. Therefore, by means of a structured questionnaire we asked senior nurses/managers at all 478 community hospitals in the UK for information on staff expertise, facilities and specialist equipment, liaison arrangements with specialist palliative care providers, priorities, practice and policy in end-of-life care.

Of the 346 hospitals (72%) that responded, only 28 were in urban areas. 73% of hospitals employed at least one nurse with additional training in palliative care, 72% had access to 24-hour specialist palliative care advice and 51% had separate overnight accommodation for relatives, but only 22% had designated palliative care beds. Most hospitals did not have written policies or guidelines for patient assessment or symptom control.

These findings add to evidence that community hospitals represent an important resource to improve access to palliative care for groups that are currently under-served.

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