From GP to palliative care expert: understanding the GPwER Palliative end of life care framework

As the general population ages with increasingly complex health needs, managing the final months of life has become more challenging, requiring greater input from multidisciplinary teams. With around 1% of people on a General Practice list approaching the end of their life at any given time, this represents a significant caseload for primary care services. Although hospital attendances typically increase during end-of-life care, most patients receive support in the community through primary care services. Evidence shows that timely, coordinated support from primary and palliative care teams can reduce unnecessary hospital visits and help people remain in their preferred place of care, often their own homes.

What is the GPwER PEOLC Framework?

With a national focus on moving care from hospitals to community settings, this framework offers GPs the opportunity to develop specialist palliative and end-of-life care skills. This enables better integrated working between primary and palliative care teams, ultimately improving support for patients and their families.

This framework builds on a GP's existing knowledge and skills, specifically focussing on palliative and end-of-life care expertise, including:

• Managing complex and long-term care – supporting people with frailty, long-term conditions and dementia, including those in the final phase of life.
• Working across systems and settings – collaborating across organiszations and community settings to support patients and those close to them.
• Education and clinical liaison – enhancing clinical practice within General Practice, localities and regions.
• Leadership and service development – driving quality improvement and service development across primary and palliative care settings.

How will / does it help colleagues/GPs?

With an increasingly frail and complex patient population entering the last phase of their lives, there is a growing need for GPs with enhanced knowledge and skills to support practices, community nursing teams and care homes in delivering effective patient care.

Enhanced clinical expertise: Developing knowledge in symptom control, psychological support, advance care planning, care of the dying and complex decision-making is essential for managing both patient and carer needs whilst facilitating people to remain in community settings.

Practice-based leadership: A GPwER can serve as the clinical "expert" within a practice, providing leadership, education and support to colleagues. This includes working closely with local palliative care services to coordinate care for people with more complex needs requiring specialist input.

Bridging primary and specialist care: Some GPwERs may work sessions within palliative care services to further develop their knowledge and skills. This creates a more seamless interface between primary and palliative care, benefiting both patients and healthcare teams through improved communication and shared expertise.

How can GPs get the most out of the framework?

GPs can use this framework to develop their knowledge, confidence and skills in palliative and end-of-life care through a variety of flexible learning approaches.

Learning resources available: The framework provides numerous resources including reading materials, e-learning modules, courses, podcasts, and opportunities for further study at diploma, certificate or master's level. These resources can be integrated into professional development plans and feed directly into the appraisal process.

Career development pathways: Some GPs may wish to develop their expertise further to take on senior clinical and leadership roles within primary and palliative care services. The framework supports this progression through structured learning and practical experience.

Supporting colleagues and improving care: GPs who undertake additional clinical work and study through the GPwER framework will be better equipped to support practice colleagues in delivering safe, effective and timely palliative care to patients and their families. This creates a ripple effect of improved knowledge and confidence across the primary care team.