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164 Compassionate communities’: a qualitative study exploring the views of general practitioners

Introduction General Practitioners (GPs) face challenges when providing palliative care, including an ageing, multimorbid population, falling GP numbers and increasing demand. A ‘public health palliative care’ (PHPC) approach is gaining momentum, and is defined as ‘working with communities to improve people’s experience of death, dying and Bereavement’. ‘Compassionate communities’ is one example, supporting patients by linking professional health carers and community networks. Primary care is central to the approach, which has been incorporated into General Practice Daffodil Standards, however there is little evidence of GP perspectives of these approaches. Our aim, therefore, was to explore GP perceptions of PHPC and ‘compassionate communities’. Methods Using snowball sampling, GPs were recruited through university teaching and research networks. Additionally, purposive sampling ensured wide representation of gender, level of experience and practice populations. Following informed consent, semi-structured, digitally audio-recorded interviews were conducted. Interviews were transcribed verbatim, and thematic analysis was undertaken. Interviews continued until data saturation was reached. Results Nine GPs were interviewed. Most were unfamiliar with ‘compassionate communities’, but recognised examples within their practice. Three themes identified perceived benefits of the model: ‘increasing awareness of community services’; ‘combatting taboo’; and ‘embracing health outside of healthcare’. Three themes identified perceived barriers: ‘limited time and funding’; ‘patient safety concerns’; and ‘integration with current care’. Some GPs perceived the PHPC approach as a distinct social issue outside of ‘proper’ palliative care and General Practice. Others envisaged a GP ‘signposter’ role, supporting a community-led system. Conclusion GPs recognised the importance of the wider community in caring for palliative care patients, but had differing views regarding the application of ‘compassionate communities’ and their position within this. Understanding more about the model’s practical implementation and exploring potential service-users’ views would help establish the feasibility of ‘compassionate communities’ in practice.