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Palliative Care in Ireland

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Palliative Care in Ireland

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    1. Palliative Care in Ireland Dr Regina McQuillan MRCPI Irish Palliative Medicine Consultants Association

    3. Modern Palliative Care Active Palliative Care Hospice Home Care Hospice Units

    4. Irish Healthcare System 11 Health Boards 1/3 of population of 3.5 million lives in greater Dublin area Scattered rural population (distances!) State funded hospital care Primary care � public and private

    5. Charitable Agencies and NGOs Irish Assoc. for Palliative Care Irish Hospice Foundation Irish Cancer Society Irish Palliative Consultants Assc Local Hospice Groups

    6. National Advisory Committee on Palliative Care Established by Minister for Health Report adopted as Government policy in 2001

    7. Core definition �WHO definition Level One � palliative care approach Level Two � general palliative care Level Three � specialist palliative care All three levels to be provided in all Health Boards Patients should be able to engage easily with level of expertise most appropriate to their needs No restrictions re age, diagnosis, other treatment

    8. Specialist Palliative Care Service Staff with recognised post qualification training and clinical experience Medical, nursing, physiotherapists, social workers occupational therapists, speech and language therapists, pharmacists and nutritionists etc

    9. Specialist Palliative Care Units Core element of specialist palliative care service Staffing Environment

    10. Specialist Palliative Care & Acute General Hospitals Specialist Teams Led by palliative medicine consultant Advise and support other health care professionals Seamless service

    11. Palliative Care in the Community Provided by General Practitioner and Public Health Nurse Specialist palliative care led by specialist unit Available to all in community � home, nursing home, community hospital

    12. Bereavement Support General bereavement support Normalise grief Some bereaved need counselling An integral part of palliative care

    13. Education, Training & Research Academic Departments Nursing development units Core curriculum for all undergraduate health care professionals Research

    14. Funding Statutory funding on a phased basis to meet the core running costs of all specialist palliative care services Protected budget Partnership between health boards and voluntary and charitable services providers

    15. Paediatric Palliative Care Consultant Specialist Nurse Needs Assessment

    16. Palliative Medicine Speciality recognition 1995 4 year specialist registrar training scheme established in 1999 Currently 8 specialist registrars in training Reciprocal recognition with UK

    17. Palliative Nursing Background - education Influence on current development Future recommendations

    18. Education and training 1987 First nurse tutor at Our Lady�s Hospice Week-long courses 8 week courses Day courses, seminars, updates

    19. Influencing factors on current development Shaping a healthier future 1994 Palliative medicine specialty 1995 National Cancer Strategy 1996 Report of the Commission on Nursing 1998

    20. Recommendations from Commission Two levels of specialist nurse Clinical Nurse Specialist Advanced Nurse Practitioner

    21. Influencing factors on current development Shaping a healthier future 1994 Palliative medicine specialty 1995 National Cancer Strategy 1996 Report of the Commission on Nursing 1998 Changes in Nurse education � Higher Diploma 1998 Report of the National Advisory Committee on Palliative Care 2001

    22. Recommendations National Advisory Report Nursing practice development unit Clinical practice development co-ordinator Development of University Courses

    23. Implications for Palliative Care Nurses (Career pathway) Staff nurse in palliative care Home care nurse Ward sister/ Nursing administration

    24. Current career pathway Staff nurse in palliative care Clinical Nurse Manager I, II, III Directors of Nursing - Clinical Nurse Specialist in Community Advanced nurse practitioner - Clinical Nurse Specialist in Acute Hospital Setting

    25. Evolving context Early referrals, shift of focus Different services at different stages of development Fears and concerns

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