Improving terminal care at home: can district nurses act as catalysts?

District nurses from eight general practices in Devon attended a 3-day course on‘Improving terminal care for cancer patients at home’. The course was learner-centred. It was designed to motivate the nurses to introduce management changes aimed at improving terminal care in the practices in which they worked. Follow-up over 3 years showed that in each practice improved communication had taken place between the nurses and doctors. The doctors had greater understanding of the nurses’roles and skills.