title: Community hospitals: an under-recognized resource for palliative care.
abstract: In the UK there are concerns that, in certain groups of dying patients such as the old, those with non-cancer diagnoses and those in rural areas, the quality of care is unacceptably variable. There has been no systematic survey of the extent to which community hospitals provide general palliative care for such patients. Therefore, by means of a structured questionnaire we asked senior nurses/managers at all 478 community hospitals in the UK for information on staff expertise, facilities and specialist equipment, liaison arrangements with specialist palliative care providers, priorities, practice and policy in end-of-life care. Of the 346 hospitals (72%) that responded, only 28 were in urban areas. 73% of hospitals employed at least one nurse with additional training in palliative care, 72% had access to 24-hour specialist palliative care advice and 51% had separate overnight accommodation for relatives, but only 22% had designated palliative care beds. Most hospitals did not have written policies or guidelines for patient assessment or symptom control. These findings add to evidence that community hospitals represent an important resource to improve access to palliative care for groups that are currently under-served.
authors.affiliation: Palliative and End-of-Life Care Research Group, University of Sheffield, Bartolome House, Winter Street, Sheffield, UK. s.a.payne@sheffield.ac.uk
authors.forename: Sheila
authors.initials: S
authors.lastname: Payne
authors.forename: Chris
authors.initials: C
authors.lastname: Kerr
authors.forename: Sheila
authors.initials: S
authors.lastname: Hawker
authors.forename: David
authors.initials: D
authors.lastname: Seamark
authors.forename: Carol
authors.initials: C
authors.lastname: Davis
authors.forename: Helen
authors.initials: H
authors.lastname: Roberts
authors.forename: Nicola
authors.initials: N
authors.lastname: Jarrett
authors.forename: Paul
authors.initials: P
authors.lastname: Roderick
authors.forename: Helen
authors.initials: H
authors.lastname: Smith
mesh_terms: D006276:Health Facility Size; D006282:Health Personnel / Q000706:statistics & numerical data; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D010166:Palliative Care / Q000706:statistics & numerical data*; D012423:Rural Health; D018881:Suburban Health; D006113:United Kingdom