Simone Cernesi

Simone Cernesi

Primary Care Trust, Sassuolo, Modena


Do General Practitioners, Patients and Caregivers Need an Additional Framework for Palliative Care in the Community?


In Italy, palliative care is provided by general practitioners who offer the first level of palliative care [1] but many patients continue to have difficulty in accessing palliative care services, especially elderly patients [ 2],[3] o r nononcological patients [ 4]. These people could be defined “neglected patients”. An instrument like “Gold Standard Framework” [ 5],[6],[7] with some adaptations for Community Palliative Care could improve access to palliative care services for neglected patients and help patients and caregiver orientate themselves in the palliative care service network more easily. The aim of this research is recognize opinions from GPs, including doctors who work in out of hours services, and from caregivers and members of patients associations regarding a standard framework modified for local community palliative care services.


Qualitative research through focus group methodology shall be used. Two different focus groups, one with GPs and out of hours M.Ds, with different ages and backgrounds, and the second with caregivers and members of patients associations will be conducted in to collect opinions, ideas and problems. Before the start of the focus group, the original Gold Standard Framework and some possible changes for the local palliative care network will be summarised.


The goal is create and update a local charter of services regarding palliative care in the community, with the aim to guide GPs and Care Giver, to use the different resources to avoid patients discomfort, because the service and resources are rapidly changing.
We expect positive feedback and a good participation on the discussion from GPs, also a good response from members of patients associations and care givers.


Strategic Purpose/Conclusions
If the participants remark on the importance of a framework, we can continue to work to implement a charter of service and working to make it visible and accessible. At least it could be an additional encouragement for discussion and progress in the local community palliative care model.


1. Centeno C, Clark D, Rocafort J, Oana D , Lynch T, Eapc Atlas of Palliative Care in Europe 2013
2. Harris D , Forget me not: palliative care for people with dementia, Postgrad Med J. 2007 Jun; 83(980):362–366.
3. Hall S, Petkova H, Tsouros A, Higginson J, Costantini M , Palliative Care for older people: better practice, W.H.O. Europe 2011.
4. Tassinari D, D rudi F, M onterubbianesi MC , S tocchi L, F erioli I, M arzaloni A, T amburini E, S artori S. E arly Palliative Care in Advanced Oncologic and NonOncologic Chronic Diseases: A Systematic Review of Literature. Rev Recent Clin Trials. 2016;11(1):6371.
5. The Gold Standard Framework . O verview of the work of the National GSF Centre in End Of Life care (Autumn 2015)
6. Carduff E, Jarvis A, Highet G, Finucan A, Kendall M, Harrison N, Greenacre J, Murray S A, P iloting a new approach in primary care to identify, assess and support carers of people with terminal illnesses: a feasibility study , BMC Fam Pract. 2016 Feb 11;17(1):18. doi: 10.1186/s1287501604142.
7. Moroni M , Z occhi D, B olognes i D, B ernethy A , R ondell i R, S avorani G , S alera M , D all’Olio F , G alli G , B iasco G , T he ‘s urprise question’ in advanced cancer patients: A prospective study among general practitioners, B MC Fam Pract. 2016 Feb 11;17(1):18. doi: 10.1186/s1287501604142.