Consultants Views on Barriers to Palliative Care in Two District General Hospitals in England, United Kingdom

Background: Earlier Palliative Care referrals could improve health-related quality of life. Decisions regarding Palliative Care referrals can be made by consultant doctors in some trusts within the United Kingdom and can be explored to gain more of an understanding of barriers to Palliative Care referrals. Aims: 1. Understand consultants' views on barriers to palliative care referrals and measure their subjective confidence levels in having discussions regarding End of life (EoL)/palliation. 2. To understand consultants’ views on cultural perceptions and the potential influence it may have on decisions regarding EoL/palliation. 3. Identify where consultants want more support from the Palliative Care Team across the two hospitals. Materials and Method: An anonymised survey was distributed via email to all consultants across two hospitals within a trust in England, United Kingdom over October 2024 to January 2025. In December 2024, the wording of some questions was adjusted, and a question was added. Results: In total, 27 consultants responded to the survey, and key themes were analysed by assessing recurrent topics and comparing them to the available literature. 48% of consultants indicated that they felt ‘very confident’ having discussions regarding EoL/palliative care with patients, and their next of kin. Preventative factors to Palliative Care referrals based on the survey included: challenges with collaboration, diagnostic/prognostic uncertainty, and resource availability. Common topics that respondents would like further teaching on are explored. Respondents indicated that they wanted support with symptom management (7/18 respondents, 39%, with one consultant also commenting they would like support with all 3 options), followed by support with management decisions (28%), and support with communication (17%). Three respondents selected ‘other’ and indicated that they wanted support with all 3 options. Conclusion: This study explored consultants’ views on barriers to Palliative and EoL care, including challenges with communication, resource availability, and potential knowledge gaps. This area would benefit from further quantitative study.