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

BACKGROUND: GPs 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 currently there is an absence of synthesised literature addressing this area. 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 [Cumulated Index to Nursing and Allied Health Literature]) were searched on 1 June 2022 to identify relevant primary qualitative literature published between 2008 and 2022. RESULTS: Twelve articles were included in the review. The following four themes were identified that affect GPs’ experiences of providing palliative care: lack of resources to support palliative care provision; fragmented multidisciplinary team (MDT) approach; challenging communication with patients and carers; and inadequate training to address the complexities of palliative care. Pressures caused by increasing workloads and a lack of staffing combined with difficulty accessing specialist teams impeded GPs’ provision of palliative care. Further challenges were deficiencies in GP training, and a lack of patient understanding or unwillingness to engage in palliative care discussions. CONCLUSION: A multifaceted approach focusing 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 in palliative care. Regular in-house MDT discussion of palliative cases and exploration of community resources could generate a supportive environment for GPs.