How do local doctors react to a hospice?

Abstract

Postal questionnaires were sent to general practitioner principals and hospital consultants in Ayrshire a year before and again 13 months after the opening of the Ayrshire Hospice. Seventy-three per cent of 342 doctors replied to the first survey and 62% replied to the second survey. There was initially a fairly strongly felt need for a hospice, with median Visual Analogue Score (VAS) of 16 ('definite need' = 0 and 'definitely no need' = 100). After the opening of the hospice doctors were much more enthusiastic (median VAS 5; p less than 0.0001). Doctors feeling no need for a hospice (VAS greater than 75) became fewer (9.6% before opening, 2% after). Doctors who would refer patients to a hospice, at first 82%, numbered 92% after opening. Seventy-one per cent of general practitioners and 60% of consultants had referred patients to the hospice within a year of opening. After opening, specialist advice with home care was considered the most useful aspect, in-patient beds useful, and day hospice least useful. Seventy-three per cent of referring doctors found the hospice a great help. In both surveys general practitioners and consultants felt the hospice should be run by a mixture of voluntary and NHS finance. Doctors appeared willing to learn about palliative care from hospice doctors, particularly after hospice opening. Doctors were initially rather dissatisfied with palliative care in existing hospitals, but became less so (particularly about pain control) after hospice opening. Surprisingly, in both surveys the attitudes of general practitioners and consultants were virtually identical.(ABSTRACT TRUNCATED AT 250 WORDS)