2 The role of primary care in providing bereavement support: perspectives from a community sample

Background Around 5 00 000 people die in England and Wales each year, leaving approximately 2 million people experiencing close bereavement. Around 15% will develop a complex grief reaction requiring specialist support. GPs are often the first point of contact in the health services for bereavement support: GP consultations increase after a loss. GPs therefore have a central role in providing bereavement support and in identifying those at higher risk. Experiences and perceptions of primary care bereavement support are not well defined. Methods Sixty three recently bereaved people were recruited via Registry Officers at the death registration appointment. A sub-sample of 14 participated in in-depth interviews within five months of bereavement, exploring their perceptions and experiences of primary care bereavement support. Audio recordings were transcribed verbatim, and analysed using a framework approach. Results The nature of grief varied across the sample, shaped by prior losses, relationship with the deceased, and presence of sequential losses. GP support was one aspect of a broader picture of support provision. Barriers and facilitators of the use of primary care for bereavement support included: difficulty with securing appointments, prior relationships with the GP, the appropriateness of accessing general practice for a non-physical complaint, and expectations of how the GP might help. These served to either encourage or discourage potential help-seeking in bereavement. When the bereaved were registered at a different GP practice from one that had provided consistent GP palliative care for the deceased, bereavement care was particularly difficult. Discussion Understanding bereaved peoples’ perceptions of the role of the GP and the wider primary care team as a source of bereavement support, and the factors encouraging or discouraging such help-seeking in bereavement can enable primary care to optimise the provision of person-centred bereavement support.