Advance care planning in primary care in the East of England: a qualitative study

The aim of this study as part of an academic GP specialist registrar training was to investigate current practice in advance care planning (ACP) in UK primary care, seeking to establish what is good practice in ACP in this setting, and to identify to what extent the Royal College of Physicians guidance on ACP is already integrated into clinical practice. The study involved GP interviews, questionnaires and focus groups with lay and patient advocacy groups.

3 literature review papers published as part of this research, explore why making treatment decisions for older people are difficult due to a complexity of potential co-morbidities and the loss of capacity to tell their doctors what they want.  ACP should help with making those decisions clearer, based on the documented preferences of what the patient would have wanted while capacity was still present. Authors advocate why ACP should be preferentially carried out in in primary, rather than secondary care, but question ACP integration in into QOF and routine part of care.The implementation of ACP in primary care is likely to be most effective only if carried out in an individualised manner, tailored to particular patients’ needs.