title: Impact of the Powys Macmillan GP clinical facilitator project: views of health-care professionals.
abstract: The UK charity, Macmillan Cancer Relief, commissioned a 3-year pilot project employing 12 GP clinical facilitators (GPCFs). The aim was to raise the standard of generalist palliative care, provide extended clinical palliative care and provide a coordinated framework for commissioning specialist palliative and cancer care in Powys, rural Wales. As part of the comprehensive evaluation, surveys of GPCFs, GPs, district nurses and community hospital nurses were undertaken in order to record changes in palliative care activity, specialist palliative care services and training needs. Services providing 24-hour nursing and social services were perceived as in need of development. Referrals to Macmillan nurses increased by 40% and GPs reported that time spent on palliative care increased, on average, from a quarter of a day to half a day per week, although district nurses reported a reduction in palliative care activity. The majority of nurses thought that the GPCF's contribution was important. The use of local palliative care guidelines increased significantly among district nurses by the end of the project.
authors.affiliation: University of Sheffield, Trent Palliative Care Centre, Sykes House, Little Common Lane, Abbey Lane, Sheffield S11 9NE, UK. bill.noble@sheffield.ac.uk
authors.forename: Bill
authors.initials: B
authors.lastname: Noble
authors.forename: Philippa
authors.initials: P
authors.lastname: Hughes
authors.forename: Christine
authors.initials: C
authors.lastname: Ingleton
authors.forename: Jane
authors.initials: J
authors.lastname: Berg
authors.forename: David
authors.initials: D
authors.lastname: Clark
mesh_terms: D001291:Attitude of Health Personnel; D003152:Community Health Nursing / Q000458:organization & administration; D005194:Family Practice / Q000193:education / Q000458:organization & administration*; D006801:Humans; D020380:Needs Assessment; D009720:Nurse Clinicians / Q000193:education / Q000458:organization & administration* / Q000523:psychology; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D009859:Oncology Nursing / Q000193:education / Q000458:organization & administration*; D010166:Palliative Care / Q000458:organization & administration*; D015397:Program Evaluation; D011637:Public Health Nursing / Q000458:organization & administration; D012017:Referral and Consultation / Q000458:organization & administration; D013222:State Medicine; D011795:Surveys and Questionnaires; D014852:Wales; D016526:Workload