The British journal of general practice : the journal of the Royal College of General Practitioners
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Multicenter Study
Dying at home: a qualitative study of family carers' views of support provided by GPs community staff.
Dying at home is the preference of many patients with life-limiting illness. This is often not achieved and a key factor is the availability of willing and able family carers. ⋯ The requirement for continuity in delivering complex end-of-life care has long been acknowledged. Family carers in this study suggested that minimising the number of carers involved in care, increasing or ensuring personal continuity, and maximising the informational and organisational aspects of care could lead to a more positive experience.
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Doctor-patient continuity is popular with patients and practitioners, and is associated with better outcomes; however, changes in policy and practice organisation have diminished its scope. Although there has been some discussion of safety implications from professionals' perspective, patients' views remain largely unexplored. ⋯ Relationship continuity and choice of GP were important safety strategies, neither of which is adequately supported by recent policy changes.
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Child health care is an important part of the UK general practice workload; in 2009 children aged <15 years accounted for 10.9% of consultations. However, only 1.2% of the UK's Quality and Outcomes Framework pay-for-performance incentive points relate specifically to children. ⋯ Producing valid primary care quality indicators for children is feasible but difficult. These indicators require piloting before wide adoption but have the potential to raise the standard of primary care for all children.