Variations in out of hours end of life care provision across primary care organisations in England and Scotland

Timely access to high quality appropriate end of life care in the out of hours
period has been reported to be a key factor in enabling patients at the end
of life to be able to remain at home, if this is their wish. Deficiencies in out
of hours end of life care have long been recognised. Most out of hours end
of life care is provided by generalists: health care professionals who,
although often expert in their own field, have not had specialist palliative
care training. Research into generalist out of hours end of life care is
limited. A scoping report on generalist end of life care funded by the
National Institute of Health Service Delivery and Organisation programme
concluded that research is needed ‘to define and evaluate models of
generalist out of hours care at the end of life within a systems approach,
taking account of different providers … ’ Before research into this can take
place, however, more information is needed about how this care is currently
provided, about variations in service provision, and whether identifiable
models of service provision exist from a systems perspective.