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Table 7 Organisational Issues

From: Palliative care specialists’ perceptions concerning referral of haematology patients to their services: findings from a qualitative study

‘Fast-track’ discharge home or to the hospice

‘in haematology patients…can you get people home quick in a very fast changing situation? If you’ve got lung cancer and somebody thinks they’re starting to die, you often have a window to get people home, whereas haematology… you might have a few hours’ (SPC doctor 6)

‘sometimes you can get a [hospice] bed the next day, sometimes you can wait two weeks or more’ (SPC doctor 6)

Lack of GP involvement and impact on the provision of end of life care

‘some GPs, they have haematology patients and they are diagnosed and they don’t see them for two years, three years and then suddenly there is no more treatment for them, they’re discharged home and they’ve [GPs] kind been out of the loop’ (SPC nurse 8)

‘if you’ve got to frequently come to hospital and see the doctors, you don’t tend to find that they also frequently see their GP…so [patients] don’t have the same relationships with the community support staff as some other patients’ (SPC doctor 2)

Access to shared records

‘we’d only get the paper records from haematology anyway…so we don’t really know if any advanced planning [had taken place]…so it’s a big void there’ (SPC nurse 1)