title: Out-of-hours palliative care provided by GP co-operatives in the Netherlands: a focus group study.
abstract: BACKGROUND
  In the Netherlands, out-of-hours primary care has been re-organized from small on-call rota groups to large-scale GP co-operatives. However, out-of-hours palliative care is an area of concern. According to studies in the UK, the transfer of information about terminally ill patients to GP co-operatives seems to be poor, resulting in care that is often inadequate. Our aim was to investigate the experiences of GPs in the Netherlands about the quality of out-of-hours palliative care provided by GP co-operatives, and to identify elements of care that might need to be improved.
  
  
  METHODS
  
  
  
  METHODS
  General practice.
  
  
  METHODS
  Qualitative study, using three focus group discussions, analysed in a qualitative descriptive approach.
  
  
  RESULTS
  GPs participating in the focus groups, considered the quality of out-of-hours palliative care that is provided by GP co-operatives to be meagre. The service provided by the co-operatives was designed for acute medical problems, rather than for palliative care needs. The GPs reported three major problems: ( 1 ) lack of adequate information at the GP out-of-hours service; ( 2 ) lack of anticipatory care during office hours; and ( 3 ) absence of a palliative care policy in the GP co-operatives.
  
  
  CONCLUSIONS
  Although GP co-operatives are capable of providing continuity in palliative care, improvements could be achieved if GPs and GP co-operatives address the problems mentioned above.
authors.affiliation: Department of General Practice, and EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. schweitz@tiscali.nl
authors.forename: Bart
authors.initials: B
authors.lastname: Schweitzer
authors.forename: Nettie
authors.initials: N
authors.lastname: Blankenstein
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
authors.forename: Henriëtte
authors.initials: H
authors.lastname: van der Horst
mesh_terms: D039602:After-Hours Care / Q000458:organization & administration* / Q000592:standards; D003266:Continuity of Patient Care; D003299:Cooperative Behavior; D005260:Female; D017144:Focus Groups; D058006:General Practice; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D009426:Netherlands; D010166:Palliative Care / Q000458:organization & administration* / Q000592:standards; D036301:Qualitative Research; D058996:Quality Improvement; D011787:Quality of Health Care