PT - JOURNAL ARTICLE AU - Allison Worth AU - Kirsty Boyd AU - Marilyn Kendall AU - David Heaney AU - Una Macleod AU - Paul Cormie AU - Jo Hockley AU - Scott Murray TI - Out-of-hours palliative care: a qualitative study of cancer patients, carers and professionals DP - 2006 Jan 01 TA - British Journal of General Practice PG - 6--13 VI - 56 IP - 522 4099 - http://bjgp.org/content/56/522/6.short 4100 - http://bjgp.org/content/56/522/6.full SO - Br J Gen Pract2006 Jan 01; 56 AB - Background New out-of-hours healthcare services in the UK are intended to offer simple, convenient access and effective triage. They may be unsatisfactory for patients with complex needs, where continuity of care is important.Aim To explore the experiences and perceptions of out-of-hours care of patients with advanced cancer, and with their informal and professional carers.Design of study Qualitative, community-based study using in-depth interviews, focus groups and telephone interviews.Setting Urban, semi-urban and rural communities in three areas of Scotland.Method Interviews with 36 patients with advanced cancer who had recently used out-of-hours services, and/or their carers, with eight focus groups with patients and carers and 50 telephone interviews with the patient's GP and other key professionals.Results Patients and carers had difficulty deciding whether to call out-of-hours services, due to anxiety about the legitimacy of need, reluctance to bother the doctor, and perceptions of triage as blocking access to care and out-of-hours care as impersonal. Positive experiences related to effective planning, particularly transfer of information, and empathic responses from staff. Professionals expressed concern about delivering good palliative care within the constraints of a generic acute service, and problems accessing other health and social care services.Conclusions Service configuration and access to care is based predominantly on acute illness situations and biomedical criteria. These do not take account of the complex needs associated with palliative and end-of-life care. Specific arrangements are needed to ensure that appropriately resourced and integrated out-of-hours care is made accessible to such patient groups.