What influences referrals within community palliative care services? A qualitative case study

Social Science & Medicine
C WalsheAnn Caress

Abstract

Evidence suggests that the utilisation of community palliative care services varies considerably according to different patient characteristics. Most literature describes this variability, but does not address why such differences exist. Exploring the processes underpinning referral making rather than simply describing the outcomes of referrals may further our understanding of this variability. The aim of this article was to investigate the influences on referral decisions made within community palliative care services. A qualitative case study strategy was adopted, studying three Primary Care Trusts in England, UK. Data collection used multiple methods (interviews, observation and documentary analysis) from multiple perspectives (including general and specialist palliative care professionals, patients, managers and commissioners). Two core influences on the way health care professionals made referral decisions are identified. First, their perception of their own role in providing palliative care; autonomous professionals make independent judgements about referrals, influenced by their expertise, workload, the special nature of palliative care and the relationship they develop with patients. Second, their perception about those...Continue Reading

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