346 Progress in Palliative Care 2010 Vol 18 No 6 Nurses’ feelings of ‘ownership’ of palliative care patients: findings from a qualitative case study Catherine Walshe 1 , Ann Caress 1 , Carolyn Chew-Graham 2 , Chris Todd 1 Schools of 1 Nursing, Midwifery and Social Work and 2 Community Based Medicine, University of Manchester, Manchester, UK Background: Partnership working between nurses and other health care professionals is encouraged, as is the building of professional relationships with patients and carers. It is suggested these relationships may give nurses control and a sense of ownership of patients; this may affect otherwise valued aspects of teamwork. Issues of ownership were explored in a study of referrals within community palliative care services. Subjects and Methods: Influences on referrals were studied within three primary care organisations using a qualitative case study strategy (incorporating interviews, observations and documentary analysis). Framework analysis techniques were used to facilitate within case analysis and cross case pattern matching. Results: Forty-seven interviews were conducted with a range of generalist and specialist palliative care professionals (nurses, doctors, allied health professionals), and 10 interviews with patients. Nurses in particular discussed concepts of ownership of patients. This had positive and negative effects: restricting access to a range of services, but promoting personal continuity of care. Doctors described responsibilities towards patients, which could complicate teamwork with competing feelings of responsibility and ownership from different team members. Discussion: Issues of ownership had an impact on the way nurses conducted their work, motivated by desires to both provide personal continuity to patients and to use knowledge about patients to enhance functional authority within the team. Understanding how these issues impact on care provision is essential when working towards best quality care. Keywords: palliative care, ownership, primary care, nursing, referrals, teamwork Introduction Nurses and other healthcare professionals work in particular ways to provide palliative care to patients. For example, the concept of team is central to most people’s understanding of what it means to provide palliative care, and is a core component of many definitions of palliative care. 1–3 Partnership working between professionals is promoted as a valuable way of achieving effective multi-agency and multi- disciplinary team working. 4,5 There is a clear Invited review © W.S. Maney & Son Ltd 2010 DOI 10.1179/096992610X12775428637060 Correspondence to: Catherine Walshe BNurs RGN DNcert MSc PhD RCUK, Research Fellow, School of Nursing, Midwifery and Social Work, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester M13 9PL, UK E-mail: catherine.walshe@manchester.ac.uk