Exclusive Many GPs have lost confidence in the care the NHS provides to patients at the end of their lives, with 45% claiming they do not feel confident that the health service will give them a ‘good death’, a Pulse survey reveals.
The snapshot poll of 363 GPs found only 36% who were confident in NHS end-of-life care, with some citing the variability of services around the country and that services are vulnerable to funding cuts as reasons for their lack of trust in the service they would receive.
This comes as a new report by think-tank Demos claims that receiving a ‘good death’ can be significantly affected by where people live, their ethnicity and previous contact with social care.
The survey also revealed rising concern amongst patients over the Liverpool Care Pathway, following negative media coverage, with almost one in five GPs reporting an increase in the number of patients expressing concern over themselves, or a relative, being put on the pathway in the last year.
Pulse revealed earlier this month that the RCGP had told an official enquiry into the use of the LCP that GPs were less likely to use the pathway because of ‘recent adverse publicity’.
The enquiry was set up by the DH after reports of elderly patients being refused food and water under the pathway and patients not being informed they were on the pathway.
The survey also revealed that 15% of GPs have been asked by patients about assisted suicide in the past 12 months, with four of them admitting that they had offered advice to patients, going against GMC guidance.
The RCGP is currently consulting its members on whether the college should become the first medical college or body support a parliamentary bill that would change the law on assisted dying for terminally ill patients.
Dr Paul Roblin, chief executive of Berkshire, Bedfordshire and Oxfordshire LMCs said the results of the survey were ‘worrying’ and reflected a lack of confidence in local hospitals or out-of-hours services.
He said: ‘End-of-life care is patchy. It’s up to where you live whether you get a good death, and whether you’re optimistic about getting a good death.
‘Where I live I would be confident I’d get a good death, but my one concern is that out-of-hours care is phenomenally underfunded. The waits to see an out-of-hours doctor are too long. If we have doctors spread too thinly we won’t provide good palliative care for people in their homes. We need more doctors to cover this.’
Dr Mary Hawking, a GP in Dunstable, Bedfordshire, said that end-of-life care was ‘very variable in different areas, conditions and expectations – and liable to change for financial reasons’.
Dr Moheb Shalaby, a GP in Sutton Coldfield, West Midlands said ‘patients seem to come last in the NHS nowadays – conflict of priorities between Government value-for-money targets and patients as first priority for the doctors’.
What GPs think of end-of life care
Do you have confidence in the NHS giving you a ‘good death’?
Yes – 36%
No – 45%
Don’t know – 19%
Have you noticed an increase in the number of patients saying they are concerned about themselves, or their relatives, being put on the Liverpool Care Pathway in the past 12 months?
Yes – 17%
No – 80%
Don´t know – 3%
Have you been asked by a patient about assisted suicide in the past 12 months?
Yes – 15%
No – 85%
Don’t know 0%
Source: Pulse survey of 363 GPs