Community nurses have reported feeling ‘obliged’ to take on an extended role within palliative care to cover work formerly done by GPs, but without additional pay, consultation or acknowledgement, according to a new study.

Research published in the British Journal of General Practice (BJGP) suggested that an increase in GP remote working and ‘workforce diversification’ within general practice was leaving community nurses feeling inadequately supported when it comes to end-of-life care.

The findings were based on 10 focus group interviews with 35 registered community nurses from across the UK – all of whom had provided end-of-life care for adult patients in the community in the past three months.

The study explored how two changes in primary care – including the shift towards remote working and the diversification of practice teams, by using other staff such as paramedics or physician associates – impacted the community nursing workforce.

Among study participants, researchers identified a ‘common thread’ linking concerns about the two changes, including that the relationship between community nurses and GPs had been damaged and that it was now ‘harder for nurses to get the senior clinical support they want’.

‘Without this support, nurses reported that they had felt obliged to extend their role to cover aspects of care formerly the remit of a GP, taking a lead in building the relationships with patients and their families that enabled shared decision making about complex problems,’ the study concluded.

‘Many expressed a wish for increased GP support with these difficult decisions, alongside a perception that their roles had been extended with inadequate consultation and attracted inadequate acknowledgement and remuneration.’