There is great potential for more and better palliative care in the community. Primary Health Care Teams are well placed to do so for all diseases, not just cancer. They are already undertaking much care for people with long-term conditions and many physically and cognitively frail older persons. They are present with the patient from diagnosis of the life threatening condition. Their on-going relationship with the patient facilitates social, psychological and spiritual care, and they are uniquely placed in the community to give end of life care there if the patient and carer so wish. To develop their role, family physicians, community nurses and other allied health professionals in the community will need training support, and clinical back-up from palliative care specialists, and time and finances to make this practical.

To maximise the potential inherent in Primary Care to deliver high quality end of life care to patients and family carers, in cooperation with specialist services, by:

1. helping to develop the practice of palliative care in Primary Care for people with malignant and non-malignant disease, according to their multi-dimensional needs and the needs of their family carers.
2. compiling guidelines for developing palliative care in the community in European countries. This will include a guide to best vocabulary to use, a list of instruments used to identify when patients may benefit from care, (eg PIG, NECPAL, SPICT) and how to adopt a local public health approach to planning care.
3. developing strong links and co-operation between specialist palliative care and primary palliative care within European countries

We will first undertake a number of case studies scoping the current practice of palliative care in Primary Care in various European countries, in the context of the provision of specialist palliative care, and primary care in each country, and learn what facilitates and hinders the development of primary palliative care in each country. We will specifically compile a list of terms around palliative and end-of-life care so that a common vocabulary can be proposed. We will also specifically compile a list of the different ways that patients are being identified as having palliative care needs in the representative countries. We will then, learning from these case studies write guidelines on how primary palliative care might be best developed and encouraged throughout Europe.

Year 1: case studies from different European countries, and analysis of what generic and more specific factors promote and hinder palliative care in the community. Literature review as to components of good palliatiave care in the community, including current IAHPC Delphi study. Identification of tools and ways patients are identified for palliative care, and vocabulary used. Produce a Statement of the importance of primary palliative care at a task force meeting in March 2012.

Year 2: Two stage Delphi process to document generalisable lessons and production of guidelines for promoting palliative care in the community in Europe. We have databases available for this