Bereavement care in general practice: a survey in South Thames Health Region.
BACKGROUND
Studies have shown that bereaved individuals suffer increased rates of physical and mental ill health. Bereavement support has recently been advocated as an area of prevention in primary care, with suggestions that general practitioners (GPs) should adopt protocols for the active follow-up of their bereaved patients, which relies on the early notification of deaths by hospitals and hospices. Little is known about the routine care currently provided by GPs and primary health care teams (PHCTs) to support their bereaved patients.


OBJECTIVE
To explore GPs' perceptions of patient death notifications by hospitals and hospices. To describe practice policies relating to patient deaths and the provision of bereavement support.


METHODS
Postal questionnaires were sent to senior partners of a random sample of 500 general practices in South Thames Health Region.


RESULTS
Three hundred and fifty-three practitioners responded (71%). Hospitals were perceived to be significantly slower than hospices in notifying deaths (P < 0.0001). One hundred and ninety-six practices (56%) kept death registers, 230 (65%) discussed deaths together, and 142 (40%) identified bereaved relatives. One hundred and thirty-seven practices (39%) routinely offered bereaved relatives contact with a PHCT member; while 133 (38%) supported only those who asked for help. Routine support was significantly more likely to be provided by practices that kept a death register, discussed deaths together, identified bereaved relatives, and had a special interest in palliative care.


CONCLUSIONS
GPs perceive hospitals to be slower than hospices at notifying deaths, particularly in the first 24 hours. They are divided over whether bereavement support should be proactive or reactive. Keeping a practice death register, discussing deaths together, and identifying newly bereaved relatives are activities related to providing routine bereavement care.
Harris
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T
Department of General Practice and Primary Care, St George's Hospital Medical School, London.
Kendrick
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T
D001291:Attitude of Health Personnel; D001601:Bereavement; D004739:England; D005194:Family Practice / Q000458:organization & administration*; D019538:Health Care Surveys; D017051:Hospice Care / Q000458:organization & administration* / Q000592:standards; D006747:Hospital Communication Systems / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D010821:Physicians, Family / Q000523:psychology*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires