Table 1 Study sites
Site | Type | Area of practice |
|---|---|---|
1 | GP practice service using Gold Standards Framework (primarily cancer-focused) | The practice covers an urban area as well as the surrounding more sparsely populated rural areas. A team of district nurses is attached to the practice. |
2 | Heart failure community matron service (home based nursing service for people with heart failure living in the community) | This service covers a predominantly rural area. Approximately 40% of patients referred to the service die within a year of referral. |
3 | Hospital Specialist Palliative Care Service (primarily cancer- focused) | This team support the major acute hospital in one of the network trusts. |
4 | Non-GSF Nursing Care home (providing general palliative care) | This was a residential nursing care home (30 beds) in a rural area. At the time of our study, the care home had not adopted the GSFCH (Gold Standards Framework in Care Homes) but was using the Liverpool Care Pathway. |
5 | Hospital Heart Failure Clinic | This hospital based team provides information and support. Most referrals came from hospital cardiologists/nurses. |