Table 1.

Features of the three case-study sites.

Trust A	Small PCT serving an industrial town	Mainly white economically deprived population	Trust has a small, developing inpatient hospice. Primary care provision is historically important	Early adopters of GSF	Several GPs with special interest in palliative care. Mostly large GP practices	All district nurses are practice attached
Trust B	Large PCT serving an industrial town	10% minority ethnic population, with mixed areas of deprivation and affluence	Has a large hospice with comprehensive special palliative care provision acting as a focus of the areas palliative care	Piloting GSF	No GPs with special interest in palliative care. Mix of large and small GP practices	All district nurses are practice attached
Trust C	Mid-size PCT serving an urban area	30% minority ethnic population with all areas economically deprived	No specialist palliative care provision within the PCT except for community Macmillan nursing team. Referrals made to out of area hospice	No GSF use	No GPs with special interest in palliative care Many single-handed GPs	All district nurses are practice attached

GSF = Gold Standards Framework. PCT = primary care trust.