We know that about 1% of people on a General Practitioner’s list will die each year. There has been a rise in the number of people diagnosed with cancer over recent years and this pattern is likely to continue with people living longer. Due to a higher uptake of screening, attitude to seeking medical advice, accessibility to primary care and improvements in treatment, cancer survival rates are improving. However, due to people living with co-morbidity and polypharmacy, health care needs are becoming more complex.
From quality improvement projects, we know that of the people dying each year, 75% will have palliative care needs but only a quarter will receive optimal care. As people age with increasing health problems and frailty, the trajectory of their health journey becomes unpredictable.
In 2017, a palliative and end of life care delivery plan was launched by the Welsh Government highlighting the key role primary care plays and recommended that we should be identifying people with palliative care needs, supporting people to live and die well and delivering fast and effective care. Our care should be proactive rather than reactive. The aim is to improve patient and family experience and quality of life whilst preventing unnecessary emergency hospital admissions.
Primary care is in a very privileged place to provide great palliative care. General Practitioners and the associated team will often already have a good idea of the the background of the patient, how their diagnosis came about but also appreciate the social structure surrounding the person as well as their family. In the context of palliative care, this can play a huge role and gives the patient a familiar face in these difficult times.