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111 The epidemiology of the out of hours general practioner‘s palliative workload in shropshire
  1. MP Doré and
  2. D Willis
  1. Severn Hospice, University of Chester


Introduction There is a paucity in information or standards regarding palliative care being performed by the general practioner (GP) out of hours (OOH). The need for evidence is pressing as discussions are held as to whether 24 hour specialist palliative care cover is required, or whether generalists are capable of dealing with emergency OOH palliative care.

Aim This poster seeks to provide evidence for this discussion by outlining the patient‘s demographics, the GP’s workload, social issues and symptomology encountered. By quantifying the current challenges faced, we can focus on defining what is needed in the future.

Methodology Using Shropshire Doctors Co-operative Ltd (Shropdoc’s) recorded data we have collated a representative picture of the palliative care practice over a year period from 161 OOHGP interactions.

Results Palliative care makes 11.5% of the total OOHGP Home Visits (HV). There is a positively skewed distribution with a median age 81 with 56% female. Saturday followed by Sunday are the most active days with more HV over the weekend than the rest of the week combined. Overall 56% of OOHGP HV are for patients who are expected to die within the next 48 hours with 80% of the symptoms being agitation, secretions and pain in this group. Social issues were documented in 21% of HV with multiple concerns highlighted, however adjusting for a prognosis estimated less than 48 hours the focus shifted to family distress (3x more likely) and future planning (5x more likely).

Conclusion The greatest demand is all weekend and from 17:00–21:00 throughout the week. These finding could provide weighting to arguments of provisions of OOH care. The patients seen are appropriate and the symptomology encountered is heterogeneous but the majority can be distilled to end-of-life emergency symptoms. This highlights the varied and predictable unpredictability of palliative care and a largely unrecognised contribution to social-care and future-planning OOH.

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