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In England, many deaths occur in the community, yet primary care, community services, and hospices receive under 10% of last-year public health expenditure for people in their last 12 months of life. The editorial argues that GP continuity enables earlier identification and coordinated, holistic care, and examines concerns about changes to palliative care “registers” in the 2025/2026 GP Contract.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/primary-care-must-be-prioritised-to-achieve-universal-palliative-care-editorial/407920/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/primary-care-must-be-prioritised-to-achieve-universal-palliative-care-editorial/407920.png","ImageObject",300,407,{"name":92,"@type":93},"Grenda","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is primary care considered essential for universal palliative care?","Question",{"text":113,"@type":114},"Universal palliative care is described as achievable only through primary care because GP teams can provide continuity, coordinate holistic support based on local community needs, and respond to patient needs beyond diagnosis.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What concern is raised about the 2025/2026 GP Contract changes?",{"text":118,"@type":114},"The editorial notes that retiring income-protected QOF palliative care registers may reduce incentives for GPs to identify patients with palliative care needs, according to a recently published Parliamentary Commission report.",{"name":120,"@type":111,"acceptedAnswer":121},"How do the editorial’s proposed changes relate to current identification rates?",{"text":122,"@type":114},"Despite resource and time pressures, identification of palliative care need in England increased in 2023/2024. The editorial points to this momentum and argues there is further opportunity to scale learning and adapt initiatives through networks and new GP contract investment, including CAIP payment incentives.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},407920,1790740093,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":24,"preview_page_count":4},7971474921005,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Editorials  \nPrimary care must be prioritised to achieve universal palliative care  \nSarah Mitchell, Claire Fuller, Amanda Doyle and Lucy Ziegler  \nUniversal palliative care can only be achieved through primary care  \nMore people worldwide are living with serious illness and the suffering associated with it, meaning that the need for good palliative care and end-of-life care is rising.1 The progression of the Terminally Ill Adults Bill through parliament has sparked new media and political interest in palliative and end-of-life care. Narratives pervade about challenges and failures in the delivery of palliative and end-of-life care, and the associated pain and distress experienced by patients.  \nIn England, 1% of the population dies every year, over 500 000 people, and this is expected to increase to over 640 000 by 2040.2 More people are dying in the community, with 57% of deaths occurring in community settings in 2023/2024, including in people’s homes (28%), care homes (22%), hospices and other residential settings (7%) . Palliative care is an approach focused on improving quality of life for people with life-threatening illness, through the timely identification and management of physical, psychological, social, and spiritual (or cultural) needs.  \nPrimary care, community services, and hospices collectively receive less than 10% of the £9.5 billion of public expenditure on health care for people in the last 12 months of their life in England.3 Despite this, many GP and primary care colleagues are deeply committed to the provision of palliative care to their patients. The ability to deliver continuity of care in primary care is key. Continuity in primary care is associated with less frequent use of emergency hospital care towards the end-of-life for patients of all ages, suggesting improved patient experience as well as positive healthcare system outcomes.4,5 GPs and primary care teams know the needs of the community they serve and are uniquely placed to provide holistic and coordinated care in response to patient need, not diagnosis. Universal palliative care will not be achieved without them.6  \nThis Editorial responds to changes and concerns raised in relation to palliative care‘registers’ in the 2025/2026 GP Contract, in which all income-protected Quality and Outcomes Framework (QOF) registers were retired.7 This change has caused concern among the palliative care sector at a national level, with the recently published Parliamentary Commission report Palliative Care and End-of-Life Care: Opportunities for England, stating that this change will ‘run the risk of reducing pressure on GPs to identify patients with palliative care needs’.8  \nMoving on from the idea of a palliative care‘register’  \nThe Palliative Care Register has been a feature of the QOF since 2008, worth three QOF points (or just over £600 per practice per year) . The quality of GP palliative care registers receives little scrutiny and the impact on patient care (or not) is largely unknown. Much more research is needed to understand the provision of palliative care in primary care. The existence of palliative care registers has not addressed longstanding inequity of access to specialist palliative care services. Patients with cancer, from more affluent areas, and who are White British, are more likely to receive specialist palliative care services than those with non-malignant disease, from more socioeconomically deprived areas, and from minority ethnic backgrounds.9 To date there has not been any work to understand whether this inequity is specific to specialist palliative care services, or whether this is also reflected in the identification of palliative care need and provision of care in general practice.  \nOpportunity for positive change  \nDespite current pressures, general practice is already responding to the rising patient and population need for palliative and end-of-life care. There was a 27% rise in rates of identification of palliative care need","cbCaip2J07s6MxxX","https://ap.wps.com/l/cbCaip2J07s6MxxX","pdf",80875,"English","# Primary care as the route to universal palliative care\n## Rising need and current delivery gaps\n## Continuity of care in general practice\n# Impact of GP Contract changes to palliative care registers\n## The Palliative Care Register and QOF points\n# Moving forward: opportunity for positive change","[{\"question\":\"Why is primary care considered essential for universal palliative care?\",\"answer\":\"Universal palliative care is described as achievable only through primary care because GP teams can provide continuity, coordinate holistic support based on local community needs, and respond to patient needs beyond diagnosis.\"},{\"question\":\"What concern is raised about the 2025/2026 GP Contract changes?\",\"answer\":\"The editorial notes that retiring income-protected QOF palliative care registers may reduce incentives for GPs to identify patients with palliative care needs, according to a recently published Parliamentary Commission report.\"},{\"question\":\"How do the editorial’s proposed changes relate to current identification rates?\",\"answer\":\"Despite resource and time pressures, identification of palliative care need in England increased in 2023/2024. The editorial points to this momentum and argues there is further opportunity to scale learning and adapt initiatives through networks and new GP contract investment, including CAIP payment incentives.\"}]","Primary care must be prioritised to achieve universal palliative care - Editorial | PDF",1790576889]