Challenges experienced by general practitioners when providing palliative care in the UK: a systematic qualitative literature review

Background General Practitioners in the UK will face increased palliative care demands in the coming years. Understanding what makes providing palliative care difficult for GPs is an important step to planning future services,but at current there is an absence of synthesised literature addressing this.

Aim To identify the range of issues that affect GPs’ provision of palliative care.

Design & setting A qualitative systematic review and thematic synthesis of studies exploring GPs’ experiences of providing palliative care in the UK.

Method Four databases (MEDLINE, Embase, Web of Science and CINAHL) were searched 1 June 2022 to identifyrelevant primary qualitative literature published between 2008–2022.

Results Twelve papers were included in the review. Weidentified fourthemes that affect GPs’ experience of providing palliative care: resourcing issues; poor multi-disciplinary team (MDT) approach;challenging communication with patients and carers; andinadequate training.Pressures caused by increasing workloads and a lack of staffingcombined with difficulty accessing specialistteams impeded GPs’ provision of palliative care. Deficiencies in GP training and a lack of patient understanding or unwillingness to engage in palliative care discussions werefurther challenges.

Conclusion A multifaceted approach focussed on increased resources, improved training and a seamless interface between services, including improved access to specialist palliative teams when necessary,is needed to address the difficulties that GPs face inpalliative care.Regular in-house MDT discussion of palliative cases and exploration of community resources could generate a supportive environment for GPs.