PT - JOURNAL ARTICLE AU - Julia Tapsfield AU - Charlie Hall AU - Carey Lunan AU - Hazel McCutcheon AU - Peter McLoughlin AU - Joel Rhee AU - Alfonso Leiva AU - Juliet Spiller AU - Anne Finucane AU - Scott A Murray TI - Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners AID - 10.1136/bmjspcare-2015-001014 DP - 2019 Dec 01 TA - BMJ Supportive & Palliative Care PG - e28--e28 VI - 9 IP - 4 4099 - http://spcare.bmj.com/content/9/4/e28.short 4100 - http://spcare.bmj.com/content/9/4/e28.full SO - BMJ Support Palliat Care2019 Dec 01; 9 AB - Background Key Information Summaries (KIS) were introduced throughout Scotland in 2013 so that anticipatory care plans written by general practitioners (GPs) could be routinely shared electronically and updated in real time, between GPs and providers of unscheduled and secondary care.Aims We aimed to describe the current reach of anticipatory and palliative care, and to explore GPs’ views on using KIS.Methods We studied the primary care records of all patients who died in 2014 in 9 diverse Lothian practices. We identified if anticipatory or palliative care had been started, and if so how many weeks before death and which aspects of care had been documented. We interviewed 10 GPs to understand barriers and facilitating factors.Results Overall, 60% of patients were identified for a KIS, a median of 18 weeks before death. The numbers identified were highest for patients with cancer, with 75% identified compared with 66% of those dying with dementia/frailty and only 41% dying from organ failure. Patients were more likely to die outside hospital if they had a KIS. GPs identified professional, patient and societal challenges in identifying patients for palliative care, especially those with non-cancer diagnoses.Conclusions GPs are identifying patients for anticipatory and palliative care more equitably across the different disease trajectories and earlier in the disease process than they were previously identifying patients specifically for palliative care. However, many patients still lack care planning, particularly those dying with organ failure.