Skip to main content
Article thumbnail
Location of Repository

Exploring complexity in community palliative care: a practitioner based approach to research and development

By Dan Munday


This thesis explores the complex discipline of community palliative care. Palliative patients suffer from a range of conditions, have complex, evolving clinical problems and receive care from a wide variety of health and social care professionals. Understanding these issues is central to effective service provision and maintaining continuity of care for patients and their carers. Current community palliative care provision in the UK is the result ofthe co-evolution of the emergent specialties of palliative and primary care over the past sixty years. A critical realist and practitioner based research approach is used in a multi-method study ofthe reasons for emergency admission ofpalliative patients into hospital and a qualitative study exploring the work and experiences of health care assistants prov~ding practical supportive care for palliative patients in their homes. Examining narratives of patients, carers and health professionals enables in depth exploration ofthe fundamental elements and contexts which define the inherent complexity ofthis area. Emergency admission ofpalliative patients represents a significant breach in continuity of care often resulting in disruption for both patient and health care services. The reasons for these admissions are many and complex. Relationships of power between different health professionals and between patients and health professionals exert a major influence on community palliative care provision and the process of admission. Health care assistants are relatively powerless and employed as basic carers, yet in community palliative care they undertake emotional labour, for which they draw on their personal resources. This aspect oftheir practice is crucial for patients and their carers; however it is largely unrecognised by formal health care services. Undertaking research in the context of a community palliative care team enables the development of a community of research practice. This provides an effective model for both developing an evidence base for community palliative care and the development of appropriate local services

Topics: R1
OAI identifier:

Suggested articles


  1. (1999). (1 999a) Palliative care services in the community: what do family doctors want?
  2. (2007a) Continuity in palliative care: key issues and perspectives.
  3. (I 996a) How reliable are relatives' retrospective reports of ten-ninal illness? Patients' and relatives' accounts compared.
  4. (I 998a) Dying from cancer in community hospitals or a hospice, closest lay carers' perceptions.
  5. (I 998a) Which terminally ill cancer patients receive hospice in-patient care?
  6. (1948). (I 999b) Cradle to the grave? Terminal care in the United Kingdom,
  7. (1958). (I 999c) 'Total pain', disciplinary power and the body in the work of Cicely Saunders,
  8. 1) Palliative care for non cancer patients: a UK perspective from primary care. In: Addington-Hall,
  9. 1) Ten-ninal iHness and the aged. Lancet
  10. 8) The 5 Os: 50 years of the National Health Service.
  11. (2004). A categorization and analysis of the criticisms of evidence-based medicine.
  12. (1999). A change in scientific approach: from alternation to randomised allocation in clinical trials in the 1940s.
  13. (1997). A comparison of hospice and hospital care: views of surviving spouse.
  14. (2001). A comparison of the palliative care needs of patients dying from chronic respiratory diseases and lung cancer.
  15. (2007). A good death - but no thanks to the NES.
  16. (1999). A grounded hermeneutic editing
  17. (1994). A model response. Nursing Times 90: 66-68.
  18. (2002). A model to guide patient and family care: based on nationally accepted principles and norms of practice.
  19. (1996). A personal therapeutic journey.
  20. (2003). A philosophical analysis of the evidence based medicine debate.
  21. (1995). A policy framework for commissioning cancer services: A report by the expert advisory group on cancer to the chief medical officers of England and Wales. London: Department of Health.
  22. (1996). A randomised controlled trial of the cost effectiveness of a district coordinating service for terminally ill cancer patients.
  23. (2000). A randomized controlled trial of a hospital at home service for the terminally ill.
  24. (2003). A tale of two strikes.
  25. (1987). A team approach to terminal care: personal implications for general practitioners.
  26. (2004). A training programme for healthcare support workers.
  27. (1992). A weather eye on unpredictability.
  28. (1952). A year of general practice: a study in morbidity.
  29. (2001). Action research as a form of social inquiry: a theoretical justification.
  30. (1995). Action research for health and social care: a guide to practice.
  31. (2001). Action research: a systematic review and guidance for assessment.
  32. (2001). Action science: creating communities of inquiry in communities of practice. In:
  33. (1963). Actions, reasons and causes.
  34. (2007). Advance care planning: a guide for health and social care staff. Leicester: End of Life Care Programme.
  35. (2005). Advanced heart failure: impact on older patients and informal carers.
  36. (2006). Advances in palliative care research methodology.
  37. (1999). Age is not the crucial factor in determining how the palliative care needs of people who die from cancer differ from those of people who die from other causes.
  38. (1995). Age, distance from a hospital, and level of deprivation are influential factors.
  39. (1999). An annotated bibliography of the publications of
  40. (1996). An investigation of GP referrals to palliative care services.
  41. (1995). Appropriateness of place of death for cancer patients: views of general practitioners and hospital doctors.
  42. (1994). Are bereaved family members a valid proxy for a patient's assessment of dying?
  43. (2006). Are district nurses too task orientated to meet the needs of the 21 st century?
  44. (1997). Assessing Needs and Effectiveness: is palliative care a special case. In:
  45. (2000). Assessing the predictive validity of emotional intelligence.
  46. (1995). At home in the Universe: The search for the laws of self organization and complexity.
  47. (1965). Awareness of dying.
  48. (2005). Bereaved carers'views of a hospice at home service.
  49. Better end of life care for patients - Government announces strategy to improve end of life care.
  50. (2002). Between hope and acceptance: the medicalisation of dying.
  51. (1997). Beyond cancer? In:
  52. (2003). Birth centres: a social model for community care. London: Elsevier Health Services.
  53. (1998). Book review: Modem social theory: key debates and new directions:
  54. (2003). Building on the best: choice, responsiveness and equity in the NHS. London: Department of Health.
  55. (1990). Cancer pain relief and palliative care: technical report series 804. Geneva: World Health Organisation.
  56. (2000). Cancer: from cure to care. Manchester: Hochland and Hochland.
  57. (1992). Care = organisation + physical labour + emotional labour.
  58. (1984). Care of the dying in one practice.
  59. (2007). Care of the dying is not an option but a nursing necessity.
  60. (1998). Care of the dying person in the nursing home: exploring the care assistants' contribution.
  61. (2003). Care of the dying: a pathway to excellence.
  62. (1998). Caregiving, carework and professional
  63. (2003). Caring for the dying at home: companions on the j oumey.
  64. (2003). Caring for the dying: how well prepared are general practitioners? A questionnaire study in Wales.
  65. (1998). Caring in
  66. (2004). Case management and community matrons for long term conditions.
  67. (2004). Case studies: a research strategy appropriate for palliative care?
  68. (2005). Challenging the framework for evidence in palliative care research.
  69. (1999). Changing roles in nursing: a literature review of influences and innovations.
  70. (2001). Chemotherapy for advanced colorectal cancer. Does the evidence or the doctor have the greater influence?
  71. (2007). Choice and place of death: individual preferences, uncertainty, and the availability of care.
  72. (1977). Choice of strong analgesic in terminal cancer: diamorphine or morphine.
  73. (2002). Choice" in end-of-life decision making: researching fact or fiction?
  74. (1982). Chronic illness as biographical disruption.
  75. (2002). Cicely Saunders - founder of the hospice movement. Selected letters
  76. (2006). Cicely Saunders: selected writings
  77. (2002). Clinical governance and palliative
  78. (2002). Clinical nurse specialists in palliative care. Part 1. A description of the Macmillan nurse caseload.
  79. (2002). Clinical nurse specialists in palliative care. Part 2. Explaining diversity in the organization and costs of Macmillan nursing services.
  80. (2002). Code of professional conduct. London: Nursing and Midwifery Council.
  81. (2002). Communities of practice.
  82. (2001). Community hospitals for the new millenium.
  83. (2004). Community hospitals: an under-recognized resource for palliative care.
  84. (2001). Community palliative care: the evolving role of the Macmillan nurse.
  85. (2001). Comparing like with like: some historical milestones in the evolution of methods to create unbiased comparison groups in therapeutic experiments.
  86. (1979). Comparison of places and policies for terminal care. Lancet i:
  87. (2004). Complex and contingent
  88. (2005). Complex consultations and the 'edge of chaos'.
  89. (2004). Complex interventions: how "out of control" can a randomised controlled trial be?
  90. (2006). Complex responsive processes as a theory of organizational improvisation. In:
  91. (1998). Complexity and Postmodernism: Understanding complex systems.
  92. (2001). Complexity science: the challenge of complexity in health care.
  93. (2001). Complexity theories, social theory, and the question of social complexity.
  94. (2003). Complexity Theory and Palliative Care.
  95. (1998). Complexity theory and the social sciences: an introduction.
  96. (2004). Complexityfor Clinicians.
  97. (2007). Continuing care for non cancer patients. In:
  98. (2000). Continuing care: report of a scoping exercise. London: SDO,
  99. (2003). Continuity of care: a multidisciplinary review.
  100. (2003). Continuity of care: an essential element of modem general practice?
  101. (1998). Controlled trials: the
  102. (2002). Controlling cancer pain in primary care: the prescribing habits and knowledge base of general practitioners.
  103. (1990). Cosmopolis: the hidden agenda of modernity.
  104. (2004). Critical incident technique. In: Cassell,
  105. (2001). Critical realism and health promotion: effective practice needs an effective theory.
  106. (2006). Critical realism as emancipatory action: the case for realistic evaluation in practice development.
  107. (2003). Critical realism: a way forward for evaluation research in nursing?
  108. (1994). Critical realism.
  109. (2002). Cultivating communities of practice.
  110. (2004). Current epistemological problems in evidence based medicine.
  111. (1997). Death and the general practitioner.
  112. (1993). Death from cancer at home: the carer's perspective.
  113. (2000). Death, dying and emotional labour: problematic dimensions of the bone marrow transplant nursing role?
  114. (2004). Decision support, complexity and primary health care. In:
  115. (2006). Deconstructing the evidencebased discourse in health sciences: truth, power and fascism.
  116. (2002). Defining and assessing professional competence.
  117. (2006). Defining the patient population: one of the problems for palliative care research.
  118. (2002). Development of an accredited cancer care course for HCAs.
  119. (2005). Diabetes and the quality and outcomes framework.
  120. (2006). District nurses and continuity of palliative
  121. (2003). District nurses experiences and perceptions of cancer patient referrals.
  122. (1996). District nurses' perception of palliative care at home.
  123. (2006). District nurses'triggers for referral of patients to the Macmillan nurse.
  124. (2005). Doctors in Society: Medical professionalism in a changing world. London: Royal College of Physicians of
  125. (1976). Doctors talking to patients.
  126. (1999). Does hospital at home for palliative care facilitate death at home? Randomised controlled trial.
  127. Doing qualitative research, 2 nd edn. Thousand Oaks,
  128. (1982). Domiciliary ten-ninal care: demands of statutory services.
  129. (1987). Domiciliary tenninal care: handbook for doctors and nurses.
  130. (1996). Don't think zebras": uncertainty, interpretation, and the place of paradox in clinical education.
  131. (1983). Dying at home.
  132. (1984). Dying now. Lancet i:
  133. (1958). Dying of cancer.
  134. (2002). Dying of lung cancer or cardiac failure: Prospective qualitative interview study of patients and their carers in the community.
  135. (1998). Economic science without experimentation. In:
  136. (2003). Educational opportunities in palliative care: what do general practitioners want?
  137. (2002). Effective interagency and interprofessional working: facilitators and barriers.
  138. (1972). Effectiveness and efficiency: random reflections on health services. London: Nuffield Provincial Hospitals Trust.
  139. (1999). Effects of a multidisciplinary, homebased intervention on planned readmissions and survival among patients with chronic congestive heart failure: a randomised controlled study.
  140. (1996). EL(96)85. A policy framework for commissioning cancer services: palliative care services.
  141. (1998). Emergency admissions of older people to hospital: a link with material deprivation.
  142. (2004). Emotional intelligence in nursing work.
  143. (2000). Emotional intelligence: the most potent factor in the success equation.
  144. (1996). Emotional intelligence: why it can matter more than IQ.
  145. (2003). Emotional intelligence.
  146. (2003). Emotional support and the role of clinical nurse specialists in palliative care.
  147. (1998). Emphasizing terminal care as district nurse work: a helpful strategy in a purchasing environment.
  148. (1993). Enabling more dying people to remain at home.
  149. (1999). Encounters with doctors: quantity and quality.
  150. (2006). End of life care in community hospitals: the perceptions of bereaved family members.
  151. (2004). End of Life Care Programme:
  152. (2006). End of Life Care Strategy: National Council for Palliative Care -Submission. London: National Council for Palliative Care.
  153. (2004). Ethical Issues arising from Narrative Research in Palliative Care.
  154. (2003). Ethics and evidence-based medicine: fallibility and responsibility in clinical science [Kenneth Goodman,
  155. (2000). Evaluating a palliative care education project in nursing homes.
  156. (2006). Evaluating and implementing new services.
  157. (1992). Evaluating nursing care of the terminally ill in the community: a case study approach.
  158. (1998). Evaluating Palliative Care: Establishing the Evidence Base.
  159. (2003). Evaluating the work of clinical nurse specialists in palliative care.
  160. (1994). Evaluation of a palliative care service: problems and pitfalls.
  161. (1995). Evaluation of palliative care.
  162. (1999). Evaluation of prognostic criteria for determining hospice eligibility in patients with advanced lung, heart, or liver disease.
  163. (2006). Evaluation of the education and support programme for district and community nurses in the principles and practice of Palliative Care.
  164. (2007). Evaluation of the Gold Standards Framework Macmillan Phases 3-6 (2003 -2005): Final Report. Coventry: Centre for Primary Health Care Studies,
  165. (1998). Evidence based health care at the end of life.
  166. (2001). Evidence based medicine: A paradigm shift is underway in health care. Expert voices: Volume 1. Washington DC: National Institute for Health Care
  167. (1996). Evidence based medicine: what it is and what it isn't.
  168. (1995). Evidence-based and evidence-biased medicine.
  169. (2000). Evidence-based clinical guidelines for palliative care:
  170. (2004). Evidence-based palliative care: beliefs and evidence for changing practice.
  171. (2002). Experiences and perceptions of newly prepared Health Care Assistants (Level 3 NVQ).
  172. (2002). Explaining society: critical realism in the social sciences.
  173. (1993). Exploring consumer views of care provided by the Macmillan nurse using the critical incident technique.
  174. (2003). Exploring nursing outcomes for patients with advanced cancer following intervention by Macmillan specialist palliative care nurses.
  175. (2005). Exploring nursing skill mix: a review.
  176. (2007). Facilitating good process in primary palliative care: does this enable quality performance? Family Practice (under final review).
  177. (2006). Factors influencing death at home in terminally ill patients with cancer: systematic review.
  178. (2005). Factors influencing emergency medical readmission risk in a UK district general hospital: a prospective study.
  179. (1978). Feeling at home. William Pickles lecture.
  180. (1966). Feeling the pulse. London: Queen's Institute for District Nursing.
  181. (2000). Fighting fires? - Emergency hospital admission and the concept of prevention.
  182. (2004). First Annual Report (2003-2004).
  183. (2006). Focus on the Quality and Outcomes Framework.
  184. (2000). Framework for design and evaluation of complex interventions to improve health.
  185. (1997). From cradle to grave: fifty years of the NHS. London: King's Fund.
  186. (2003). General Medical Services Contract.
  187. (1997). General practice -a post modem specialty.
  188. (1966). General Practice as an academic discipline. Lancet i:
  189. (1950). General practice in England today. Lancet i:
  190. (1981). General practice revisited.
  191. (2003). General practice vocational training in the UK: what teaching is given in palliative care?
  192. (2006). Getting a visit: How district nurses and general practitioners 'organi se' each other in primary care.
  193. (2004). Getting the measure of emotion - and the cautionary tale of emotional intelligence.
  194. (2000). Good communication is an essential part of the educational process.
  195. (2006). Good end-of-life care according to patients and their GPs.
  196. (2006). Good medical practice.
  197. (1999). GP out of hours co-operatives and the delivery of palliative care.
  198. (1995). GPs must take some responsibility.
  199. (1996). GPs' low morale is contributing factor
  200. (2004). Guidance on cancer services: improving supportive and palliative care for adults. London: National Institute for Clinical Excellence.
  201. (1943). Handbook for Queen's Nurses.
  202. (1997). Health and illness in a changing society.
  203. (2002). Health and social change: A critica t eory.
  204. (2004). Health Care Assistants.
  205. (2003). Health Professionals. In: Scambler,
  206. (1995). Heroic Death. Sociology 29: 597-613. Seale, C. (I 998a) Constructing death: the sociology of dying and bereavement. Cambridge:
  207. (2002). Historical and policy contexts. In:
  208. (2005). History and development of evidence based Medicine.
  209. (2007). History: A history of Marie Curie Cancer Care.
  210. (1978). Home or hospital? Terminal care as seen by surviving spouses.
  211. (2007). Hospice at home service: the carerýs perspective. Supportive Care in
  212. (1980). Hospice care - redressing the balance in medicine.
  213. (2004). Hospital at home for patients with acute exacerbations of chronic obstructive pulmonary disease: systematic review of evidence.
  214. (2004). House of Commons Health Select Committee
  215. (2002). How and why do GPs use specialist palliative care services?
  216. (1998). How do cancer patients who die at home differ from those who die elsewhere?
  217. (2001). How to change reality: story vs structure a debate. In:
  218. (2002). How well do general practitioners deliver palliative care? A systematic review.
  219. (2000). How well do we care for patients with end stage chronic obstructive pulmonary disease (COPD)? A comparison of palliative care and quality of life in COPD and lung cancer.
  220. (1993). Hypertension guidelines: other diseases complicate management.
  221. (2001). Illness narratives: fact or fiction?
  222. (2005). Illness trajectories and palliative care.
  223. (2005). Illustrating triangulation in mixed-methods nursing research.
  224. (1995). Improving terminal care at home: can district nurses act as catalysts.
  225. (1999). In the teeth of evidence: the curious case of evidence based medicine.
  226. (2001). Inappropriate admissions: thoughts of patients and referring doctors.
  227. (1999). Infonnal care and tenninal illness. Health and Social Care in
  228. (2001). Inpatient palliative medicine is evidence based.
  229. (2006). Integrating evidence into clinical practice: an alternative to evidence-based approaches.
  230. (2002). Interpreting quantitative data.
  231. (2000). Interprofessional working in palliative care in the community: a review of the literature.
  232. (2004). Introducing empiricism.
  233. (2002). Introduction - many voices: human values and healthcare ethics. In:
  234. (1998). Introduction and overview. In:
  235. (2007). Introduction: concepts, scope and models of continuity in palliative
  236. (2003). Introduction: The discipline and practice of qualitative research.
  237. (1999). Is care of the dying improving?
  238. (1996). Is there a research paradigm for palliative care?
  239. (1992). Joint report of the standing medical advisory committee & standing nursing & midwifery advisory committee: The principles and provision of palliative care.
  240. (2007). Key challenges and ways forward in researching the "good death": qualitative in-depth interview and focus group study.
  241. (1999). Key infon-nant interviews. In:
  242. (2003). Kuhn vs Popper: the struggle for the soul of science.
  243. (1993). Lee's synopsis of anaesthesia.
  244. (1973). Life before death. London and Boston: Routledge and Kegan Paul.
  245. (2004). Living with advanced heart failure: a prospective, community based study of patients and their carers.
  246. (2001). Living with failing lungs: the doctor-patient relationship.
  247. (2006). Macmillan Cancer Support: Our History. http: //www. macmiIlan. ora. uk/About Us/Why we exist/Our history. aspx (Accessed 17/02/07).
  248. (2000). Macmillan carer schemes in England: results of a multicentre evaluation.
  249. (2005). Making claims on nursing work: Exploring the work of healthcare assistants and the implications for registered nurses' roles.
  250. (2004). Making realism work,
  251. (2001). Managing a disrupted lifecourse: issues of identity and emotion work.
  252. (2006). Managing policy research in nursing.
  253. (2002). Marie Curie nurses: enabling patients with cancer to die at home.
  254. (2001). Meaning and measurement: an inclusive model of evidence in health care.
  255. (2000). Measuring appropriate use of acute beds: A systematic review of methods and results.
  256. (2000). Medical autonomy and the UK state
  257. (2000). Medical choices and medical chances: How patients, families and physicians cope with uncertainty. Lincoln NE:
  258. (2005). Medical generalists: connecting the map and the territory.
  259. (2006). Medical intuition.
  260. (1997). Medical power and social knowledge.
  261. (2001). Medical records as catalogues of experience. In:
  262. (2002). Medical uncertainty revisited. In:
  263. (2002). Meeting complex needs: an analysis of Macmillan nurses' work with patients.
  264. (2006). Methodological and structural challenges in palliative care research: how have we fared in the last decades?
  265. (1997). Methodological issues in effectiveness research on palliative cancer care: a systematic review.
  266. (1998). Mixed methodology: combining qualitative and quantitative approaches. Thousand Oaks,
  267. (2000). Models of emotional intelligence.
  268. (1998). Modem social theory: key debates and new directions, by Derek Layder.
  269. (1997). Modem social theory: key debates and new directions.
  270. (1997). Modern social theory: key debates and new directions.
  271. (2005). More public health theory please - but make it adequate.
  272. (2001). Morphine and altemative opioids in cancer pain: the EAPC recommendations.
  273. (2007). Multimorbidity's many challenges.
  274. (1999). Narrative approaches to qualitative research in primary
  275. (1999). Narrative based medicine: narrative based medicine in an evidence based world.
  276. (1999). Narrative based medicine: Stories we hear and stories we tell: analysing talk in clinical practice.
  277. (1999). Narrative based medicine: why study narrative?
  278. (2002). Narrative in social research. In:
  279. (1988). Narrative knowing and the human sciences.
  280. (2004). Narratives of spirituality and religion in end of life care.
  281. (2002). National cancer control programmes: policies and managerial guidelines. Geneva: World Health Organisation.
  282. National service framework for coronary heart disease.
  283. (2006). National standards relating to healthcare support workers in Scotland - consultation document. Edinburgh: Scottish Executive.
  284. (1994). Need for rigorous assessment of palliative care.
  285. (1993). New strategies in social research.
  286. (2007). NFIS walk-in centres.
  287. (2005). Now nobody falls through the net": practitioners' perspectives on the Gold Standards Framework for community palliative care.
  288. (1999). Nurse' perceptions of specialist palliative care in an acute hospital.
  289. (2004). Older people's views about home as a place of care at the end of life.
  290. (1969). On death and dying.
  291. (2002). One-year mortality among unselected outpatients with heart failure.
  292. Our health, our care, our say: a new direction for community services. London: Department of Health.
  293. (2002). Out of Hours and Emergency Palliative Care. In:
  294. (2000). Out of hours care: ensuring accessible high quality care for all groups of patients.
  295. (2000). Out of hours palliative care - bridging the gap.
  296. (2007). Out of hours primary care -a shambles?
  297. (2006). Out-of-hours palliative care: a qualitative study of cancer patients, carers and professionals.
  298. (1997). Outcome measures in palliative care for advanced cancer patients: a review.
  299. (2003). Oxford companion to the history of modern science.
  300. (2000). Paid attendant carers hold important and unexpected roles which contribute to the lives of people with brain injury.
  301. (2005). Pain and palliative care: the emergence of new specialties.
  302. (2001). Palliative care and geriatric medicine: shared concerns and shared challenges.
  303. (2001). Palliative care and nursing homes: where next?
  304. (1998). Palliative Care at home: an audit of cancer deaths in Grampian region.
  305. (2002). Palliative care for heart failure.
  306. (2005). Palliative care for patients with cancer: district nurses' experiences.
  307. (2004). Palliative care in care homes for older people. London: National Council for Palliative
  308. (1998). Palliative care in chronic obstructive airways disease: a needs assessment.
  309. (2005). Palliative care in the community for cancer and end-stage cardiorespiratory disease: the views of patients, lay-carers and health care professionals.
  310. (1994). Palliative care in the community: setting practice guidelines for primary care teams.
  311. (2000). Palliative care in the community: the challenge for district nurses.
  312. (2007). Palliative care in the community.
  313. (1995). Palliative care is integral to practice.
  314. (2000). Palliative care provided by GPs: the carer's viewpoint.
  315. (2002). Palliative care research: trading ethics for an evidence base.
  316. (2005). Palliative care teams: effective through moral reflection.
  317. (2005). Palliative Care: Perspectives on caring for dying people in London. London: Kings Fund.
  318. (2001). Palliative Carefor Non-Cancer Patients,
  319. (1993). Palliative medicine -a time for definition.
  320. (1992). Palliative medicine -just another specialty?
  321. (1988). Palliative Medicine: a new speciality.
  322. (1998). Palliative medicine: is it really specialist territory?
  323. (1998). Palliative Medicine. 2nd edn,,
  324. (1998). Palliative terminal cancer care in community hospitals and a hospice: a comparative study.
  325. (1998). Palliative terminal care.
  326. (1967). Passing on: the social organisation of dying. Eaglewood Cliffs,
  327. (2007). Patient and carer perspectives of continuity in palliative
  328. (2004). Patient safety and quality of care: the role of the health care assistant.
  329. (1995). Patients have rising expectations. BMJ310: 867c-868.
  330. (2005). Patterns and predictors of place of cancer death for the oldest old.
  331. (1960). Peace at last. London: Calouste Gulbenkian Foundation.
  332. (2000). Perceived skills in palliative medicine of newly qualified doctors in the U.
  333. (2004). Perception of training for care attendants employed in the care of older people.
  334. (2005). Pharmacological treatment of peripheral neuropathic pain conditions based on shared commonalities despite multiple etiologies.
  335. (2001). Philosophy of social science.
  336. (2005). Philosophy of the social sciences.
  337. (2000). Place of care in advanced cancer: a qualitative systematic literature review of patient preferences.
  338. (1998). Place of death and access to home care services: are certain patient groups at a disadvantage.
  339. (2003). Place of death: Hobson's choice or patient choice.
  340. (2004). Place of death: preferences among cancer patients and their carers.
  341. (2004). Poems from the heart: living with heart failure.
  342. (1983). Political anatomy of the body: medical knowledge
  343. (2007). Postscript: palliative care continuity in the new
  344. (1964). Preventative medicine and public health. 5 th edn.
  345. (1999). Primary care group commissioning of services: the differing priorities of general practitioners and district nurses for palliative care service.
  346. (2006). Primary care in the twenty first century: an international perspective.
  347. (2000). Primary care services received during terminal illness.
  348. (1998). Primary care: core values in a changing world.
  349. (1977). Primary health care nursing.
  350. (1994). Primary medical care outside normal working hours: review of published work.
  351. (2004). Professional judgment, critical realism, real people, and, yes, two wrongs can make a right!
  352. (2000). Providing palliative care in primary care: how satisfied are GPs and district nurses with current out of hours arrangements?
  353. (2000). Qualitative research in health care: assessing quality in qualitative research.
  354. (2006). Quality of life in palliative care cancer patients: a literature review.
  355. (1992). Randomised controlled trial of effects of coordinating care for terminally ill cancer patients.
  356. (2001). Randomised controlled trial of specialist nurse intervention in heart failure.
  357. (2002). Real world research.
  358. (2004). Realism in evidence based medicine: interpreting the randomised controlled trial.
  359. (2005). Realist review -a new method of systematic review designed for complex policy interventions.
  360. (1997). Realistic evaluation.
  361. (1993). Reasons for referral to a Macmillan nursing team.
  362. (1999). Reflections on palliative care: sociological and policy perspectives.
  363. (2004). Reflexivity and social science: a contradiction in terms? In:
  364. (2005). Reform of the social sciences and the universities through action research. In:
  365. (2002). Reforming care for persons near the end of life: the promise of quality improvement.
  366. (2004). Removing the boundaries: palliative care for patients with heart failure.
  367. (2005). Reports from Medical Workforce Database. Southampton: Association for Palliative Medicine of Great Britain and Ireland.
  368. (2002). Research design in end-of-life research: state of science.
  369. (2001). Research sensitivities to palliative care patients.
  370. (2003). Research to improve end of life care in the United States: Towards a more behavioural and ecological
  371. (2004). Researching "real" language. In:
  372. (2001). Researching Palliative Care,
  373. (2003). Respite in palliative care: a review and discussion of the literature.
  374. (2003). Response to: The multidisciplinary team - fact or fiction.
  375. (1995). Rising emergency admissions.
  376. (2005). Role development in health care assistants: the impact of education on practice.
  377. (2006). Roles, service knowledge and priorities in the provision of palliative care: a postal survey of London GPs.
  378. (1986). Rules of evidence and clinical recommendations on the use of antithrombotic agents.
  379. (1995). Scapegoats: transferring blame.
  380. (1955). Section of surgery: discussion on palliation in cancer.
  381. (2001). Series editor's preface.
  382. (2000). Sick to death and not going to take any more of it. In
  383. (1948). Signs and symptoms of impending death.
  384. (1987). Silence and Truth in Death and Dying.
  385. (1998). Some aspects of clinical general practice. In:
  386. (1997). Some reactions to effectiveness and efficiency.
  387. (1998). Special not different: general practitioners accounts of their care of dying people.
  388. (1995). Specialist Palliative Care: A Statement of Definitions. London: National Council for Hospice and Specialist Palliative Care Services.
  389. (1996). Statutory and voluntary sector palliative care in the community setting: National Health Service professionals' perceptions of the interface.
  390. (2000). Stemming the tide of readmissions: patient, practice or practitioner? Reviews in
  391. (2005). Still waiting? Non-registered nurses in the NHS - an update.
  392. (1996). Strategic management and organisational dynamics. 2 nd edn.
  393. (1996). Survey of palliative care in a general practitioner unit.
  394. (2000). Symptom control following emergency admission to a district general hospital.
  395. (2004). Systematic review of the problems and issues of accessing specialist palliative care by patients, carers and health and social care professionals.
  396. (2000). Teaching palliative care principles to UK nursing home care assistants.
  397. (1965). Ten-ninal cancer at home. Lancet i:
  398. (1974). Ten-ninal care in malignant disease.
  399. (1990). Tenninal cancer care and patients' preference for place of death: a prospective study.
  400. (1985). Tenninal cancer care service: recent changes in regional inequalities in Great Britain.
  401. (1986). Terminal care at home: perspective from general practice.
  402. (1990). Terminal care in semi-rural area.
  403. (1985). Terminal care: home, hospital or hospice? Lancet i:
  404. (1999). Terminally ill patients' and lay carers' perceptions and experiences of community based service.
  405. (1998). The 60s: 50 years of the National Health Service.
  406. (1982). The care of patients dying from cancer. Journal o the Royal College of
  407. (1948). The care of the dying. The Practitioner 161:
  408. (2004). The cawing of the crow ...... Cassandra like, prognosticating woe.
  409. (1997). The Cochrane collaboration. In:
  410. (1994). The collapse of chaos.
  411. (2001). The consultation as Rubik's cube. In:
  412. (1996). The continuing rise in emergency admissions.
  413. (1998). The controlled clinical trial turns 100 years: Fibiger's trial of serum treatment of diphtheria.
  414. (1954). The critical incident technique.
  415. (1999). The dance of interpretation. In:
  416. (2006). The development of palliative care knowledge in care homes for older people: the place of action research.
  417. (1972). The Distress of Dying. British Medical Journal iii: 105-107. Dewi Rees,
  418. (1990). The divided self. an existential study of sanity and madness.
  419. (1957). The doctor, his patient and the illness.
  420. (1955). The doctor, his patient and the illness. Lancet i:
  421. (2004). The doctor, his patient, and the computerized evidence-based guideline.
  422. (2006). The effect of age on referral to and use of specialist palliative care services in adult cancer patients: a systematic review.
  423. (2000). The effect of the general practice registrar year on perceived skills in palliative care in the West Midlands.
  424. (1979). The emancipation of biographical medicine.
  425. (1992). The Emotional Labour of Nursing London:
  426. (1998). The emotional self.
  427. (1995). The essence of chaos. London :
  428. (2004). The evidence base: rock of certainty or shifting sands?
  429. (1997). The evolution of the hospice approach. In:
  430. (1965). The family doctor service: A charter from the BMA. Lancet i:
  431. (1990). The Fifth Discipline: The art and practice of the learning organisation. London: Random
  432. (2004). The first randomised trial of aspirin for heart attack and the advent of systematic overviews of trials. The James Lind Library.
  433. (1998). The foundations of social research: meaning and perspective in the research process.
  434. (1984). The genesis of chronic illness: narrative re-construction.
  435. (2006). The Gold Standards Framework.
  436. (2000). The golden age of medicine? In:
  437. (1998). The GP and professional organizations.
  438. (1995). The GP palliative care facilitator project. London: Royal College of General Practitioners.
  439. (1997). The greatest benefit to mankind: A medical history of humanity from antiquity to the present.
  440. (1988). The illness narratives: suffering, healing and the human condition.
  441. (2006). The impact of conducting a regional palliative care clinical study.
  442. (2000). The importance of 'knowing the patient': community nurses constructions of quality in providing palliative care.
  443. (1994). The influence of general practitioner community hospitals on the place of death of cancer patients.
  444. (1987). The Inner Consultation.
  445. (1971). The inverse care law. Lancet i:
  446. (1997). The invisible workers: an investigation into the pay and employment of health care assistants in the NHS.
  447. (2002). The logic of scientific discovery.
  448. (2003). The managed heart: commercialization of human feeling.
  449. (1978). The management of terminal disease.
  450. (1952). The management of the "hopeless" case.
  451. (2003). The multidisciplinary team - fact or fiction?
  452. The NHS cancer plan: a plan for investment, a plan for reform. London: Department of Health.
  453. The NHS plan: a plan for investment, a plan for refon-n. London: Department of Health.
  454. (1998). The other caring professions. In:
  455. (1995). The paradox of progess.
  456. (2001). The perceived role of the DN in palliative care.
  457. (2006). The philosophy of palliative care: critique and reconstruction.
  458. (1998). The place of metaphor and language in exploring nurses' emotional work.
  459. (1998). The politics of general practice. In:
  460. (1998). The practice. In:
  461. (1994). The primary health care non-team?
  462. (1970). The profession of medicine.
  463. (1991). The reflective practitioner.
  464. (1994). The revival of death. London
  465. (2000). The Rise and Fall of Modem Medicine.
  466. (1999). The rise in emergency admissions -crisis or artefact? Temporal analysis of health services data.
  467. (2000). The role of patient care teams in chronic disease management.
  468. (1995). The role of specialist home care teams: views of general practitioners in South London.
  469. (1998). The role of the Macmillan Carer in a new community service.
  470. (1985). The role of the receptionist in general practice: A 'dragon behind the desk9
  471. (1992). The routinization of hospice: charisma and bureaucratization.
  472. (1986). The specialist contribution to the care of the terminally ill patient: support or substitution.
  473. (1996). The structure of scientific revolutions [1962]. Third edn.
  474. (1993). The subordination of nurses in health care: towards a social divisions approach.
  475. (1990). The theory and practice of oncology: Historical evolution and present principles. London: Taylor and Francis.
  476. (1963). The treatment of intractable pain in terminal cancer.
  477. (2001). The use of acute hospital services by elderly residents of nursing and residential care homes.
  478. (2006). The William Pickles Collection. http: //www. rcýzp. orv,. uk/history -and heritage/histoEy, heritage arch i ves/archi ves/p ersonal_papers/william pickles collection. aspx . Royal College of General Practitioners (Accessed 18/07/06).
  479. (2005). The wisdom lost in knowledge: changes in the face of general practice.
  480. (1977). The work of the general practitioner: Statement by the working party of the second European conference on the teaching of general practice.
  481. (1994). The year before death.
  482. (1998). Theories in health care and research: Theories and studying the care of dying people.
  483. (2000). They'll still get the bodily care'. Discourses of care and relationships between nurses and health care assistants in the NHS.
  484. (2001). Thinking about patients.
  485. (1999). Through the looking glass of complexity: The dynamics of organisations as adaptive and evolving systems.
  486. (2002). Time spent in hospital in the last six months of life in patients who died of cancer in Ontario.
  487. (2000). Too ill to talk? User involvement in palliative care.
  488. (1995). Towards an ethos of interdisciplinary practice.
  489. (1997). Transden-nal fentanyl versus sustained-rel ease oral morphine in cancer pain: preference, efficacy, and quality of life.
  490. (1998). Triangulation in nursing research: issues of conceptual clarity and purpose.
  491. (2000). Ubiquity: The science of history of why the world is more simple than we think.
  492. (2000). Understanding articles demands an open mind. BMJ Rapid Responses http: //www.
  493. (1999). Understanding palliative care in residential and nursing homes.
  494. (2006). Understanding social theory. 2 nd edn.
  495. (1995). Use of general practitioner beds in Leicestershire community hospitals.
  496. (1999). Using Codes and Code Manuals: A Template Organizing Styles of Interpretation. In
  497. (2004). Using templates in the thematic analysis of texts. In:
  498. (2004). Valued aspects of primary palliative care: content analysis of bereaved carers' descriptions.
  499. (2002). Versatility and flexibility: attributes of the critical incident technique in nursing research.
  500. (1999). Visual expertise.
  501. (2006). Wanted - new methodologies for health service research. Is complexity theory the answer?
  502. (2000). Wellcome witnesses to twentieth century medicine volume 7: clinical research in Britain 1950-1980. London: The Wellcome Trust.
  503. (2003). What is the best way to help caregivers in cancer and palliative care?
  504. (1995). What's happening to nursing?
  505. (2000). What's so great about collaboration?
  506. (2000). Which terminally ill cancer patients in the United Kingdom receive care from community specialist palliative care nurses?
  507. (2003). Who dies in care homes for older people. In:
  508. (1998). Who needs palliative care?
  509. (2004). Why are patients with specialist palliative care needs in hospital?
  510. (2000). Why are trials in palliative care so difficult?
  511. (2003). With luck, doctors make a difference.
  512. (1967). Work-load and the general practitioner. Lancet ii:
  513. (1980). Working Group on Tenninal Care
  514. (1998). Working with emotional intelligence.

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.