Researchers from the University of Birmingham have identified strategies to improve communication during discharge from palliative care settings into the community, during an interview study of patients, carers and primary care professionals.

Palliative care is a broad approach to support and care for people with illnesses that cannot be cured and those at the end of their life, as well as those close to them. The need for palliative care is increasing due to a rise in people living for longer and with multiple complex conditions.

Patients who have received specialist palliative care interventions may be discharged from palliative care services to primary care in community settings. Despite such discharges being reasonably common, little is known about what happens during this process. Discharge is organised differently depending on location, service provider and relation to other specialties; therefore, communication is essential for safe and efficient care handover during discharge. Poor communication during discharge can lead to patient confusion and distress and prevent shared understanding of the patients’ needs by professionals, negatively impacting the quality of care.

Revealing key themes and challenges:
Researchers carried out an interview study to better understand patient, carer and healthcare professional’s communication experiences, to identify ways to improve communication between them during the discharge process.

Working in collaboration with researchers at the University of Warwick, researchers interviewed 38 participants across six specialist palliative care sites (hospitals and hospices) and six general practices. The interview study investigated their communication experiences during palliative care discharge from specialist care into community settings.

From these interviews, two key themes emerged. The first described the many ways that “discharge” was understood, which varied depending on the environment and circumstances of the patient. The second theme investigated what associations were made with better or worse transitions to primary care from palliative care. The findings identified multiple suggestions that professionals could use to improve this crucial and time-sensitive part of the healthcare journey for patients, carers and professionals.

Recommendations for better communication and safer transitions:
Researchers found that receiving written discharge information that was complete and accurate was described as effective, as the written information reinforced verbal instructions and were therefore a helpful reminder for patients and carers. They also found that it was important that clarity around medication changes were communicated effectively, as multiple medications changes are common during specialist palliative care. Lack of clarity has the potential for risk including the patient not taking medication correctly and potentially harming themselves.

Additionally, the results of the study suggested that having a set of principles for successful specialist palliative care discharge would be beneficial. Researchers have produced a principles and policy briefing document to support information handover and better enable primary care settings to support the patient’s future care.

Dr Katharine Weetman, Assistant Professor in Clinical Communication at the University of Birmingham and Chief Investigator of the study, said: ‘Discharge to a home or equivalent setting for patients who have been supported by specialist palliative care can be a stressful process for patients and carers; these discharges may represent the final discharge for a patient nearing the end of their life and are often characterised as "one chance to get it right". When this is poorly managed, the trauma and negative effects can be lasting and damaging.

‘We spoke to people with lived experience of these processes to better understand what does and does not work. The patients, carers, and professionals who took part suggested ways these discharges can be improved to benefit communication and care for all involved. When such discharges are well managed and supported, there is increased potential for people to create meaningful memories with those close to them whilst spending their time in the way and place that they choose.’

Researchers hope that the results of this study will help to improve current discharge communications with patients and carers, to better align care with patient’s needs and wishes.

Source: https://www.birmingham.ac.uk/news/2025/researchers-identify-ways-to-improve-communication-during-palliative-care-discharge