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The EAPC Task Force Development of PC in Europe

The EAPC Task Force Development of PC in Europe. PC in Austria and the surrounding countries. A 2005 preliminary report. Carlos Centeno University of Navarra Spain. EAPC. 1988 Palliative care to all who need it ONLUS 32 National Associations 21 European Countries

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The EAPC Task Force Development of PC in Europe

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  1. The EAPC Task Force Development of PC in Europe PC in Austria and the surrounding countries. A 2005 preliminary report. Carlos Centeno University of Navarra Spain

  2. EAPC 1988 Palliative care to all who need it ONLUS 32 National Associations 21 European Countries 50.000 health care workers One voice one vision

  3. EPAC Task Force on The Development of PC in Europe • to assess the degree of development of palliative care in Europe The World Health Organization (WHO) definition of the European region was considered in order to determine the 52 countries to be included in the study

  4. Objectives • Facilitate and spread information about the situation of PC in each country and in a global European context • Facilitate access to relevant information and communication between hospice and palliative care associations as well as societies or policy makers that operate in Europe • Identify key people who have studied the process of palliative care development in their own setting

  5. LITERATURE REVIEW of any published work about the development of PC in each of the countries Research reviewing the national DIRECTORIES of Services, whether published, printed or online EURO-BAROMETER International survey to boards of National Associations of Palliative Care. Qualitative study addressing opinions, strong and soft points of palliative care, challenges, etc. FACTS IN EUROPE 2005 International survey to an expert within each country Quantitative study addressing facts, numbers of teams or beds, etc. A Combination of 4 Research Methods 1 3 2 4

  6. OUTCOMES • COUNTRIES REPORTS • COMPREHENSIVE ANALYSIS • ATLAS OF PC • TF RECOMENDATIONS • A PERMANENT NET OF INFORMANTS

  7. PC in Austria and the surrounding countries. A 2005 preliminary report

  8. Introduction Others studies about PC Development in Europe

  9. Introduction EPAC TASK FORCE on The Development of PC in Europe Survey, September 2005

  10. 337 11 7 39 39 48 337

  11. 16.0 services / million h

  12. 20% ESTIMATION

  13. 3326 beds 55.4 pc beds / mill.

  14. ESTIMATION

  15. MEASURES TO PROMOTE PC

  16. ESTIMATION 1 MONTH

  17. 1997 educational pregraduate program for all nursing students 2000 palliative care into the national plan for acute care hospitals 2001 Declaration in the Austrian Parliament: 2001 May against Euthanasia, 2001 for Palliative Care 2003 PC Programme in University Graz Source: Baumgartner (Budapest, 2003)

  18. CZECH REP. development of PC is obstructed by complex obstacles the level of care for the dying is a problem not yet fully recognized major changes should be expected the availability of strong opioids in the country is very good, similar to Germany or Austria Cesta domů OSI Project team presented a PC project in Parliament Informants: Zdenek Bystricky & Martina Spinkova

  19. Hungarian hospice movement started in 1991. A few teams began their works between 1994 and 1995 with the help of Soros Foundation. Hungarian Health Law declared the Human Right of Palliative Care in 1997. After a slow increase there were around 22 teams in 2003. But lack of acceptable financing has weakened many organizations From September 2004 Health Ministry launched the new special hospice financing system. This new situation resulted in a rapid development of Hungarian hospice movement. INFORMANTS: Csaba Simko & Katalin Hedeus

  20. In 1999 when PC was developed mostly on Home Care and a few units, a strong development of new services began. The reason was the 99 law for funding hospices. Now there is a significant development of services but hospital-based palliative care programs is much less available. Also the opioids are more available since the change of the legislation on opioids in 2001. But, on the other hand, there are deficiencies in training and accreditation. INFORMANTS: Augusto Carazenni & Oscar Corli

  21. 1996 Core Instruments for PCU (Ministry of Health & PC professionals) 2004 Study, commissioned by the German Bundestag, discussing at governmental level 2005 Aachen EAPC Congress Informants: Friedemann Nauck & Birgit Jaspers

  22. PC has been increasing in the past 5 years, but there are still many cantons that do not have services. One of milestones was The Consensus Day in 2001. The Swiss Society held a consensus day in collaboration with the Swiss Cancer League on the development of PC in the country that resulted in the Manifeste de Fribourg with the basis for a PC development plan in “5 years – 5 goals” INFORMANT: Francoise Porchet

  23. The first freestanding hospice in Slovakia was expected to open in 2003, probably in Bardejov or Nitra. There is one paediatric service, called ‘Flicker’, and one adult home care service. It is estimated that the country requires 550 palliative care beds: 27 exist. Source: IOELC SLOVAKIA SLOVENIA Source: TATJANA ZARGI & IOELC At the moment PC, mostly in home settings, is provided only by one hospice as an NGO. The PC Development Institute, as NGO, is mostly providing training in this field. The commission named by the Ministry of Health has prepared National guidelines on palliative care development in the country. INFORMANTS: Csaba Simko & Katalin Hedeus

  24. UK 2005 Informant: Ann Eve

  25. development comparison? • Development is… Present (services working in pc) + Future: possibility to develop (the vitality of PC movement) could we measure that? could we build a EAPC 2005 SCORE on the development of PC in Europe?

  26. UK 2005 An EAPC SCORE on The Development of PC in EUROPE (*) Range (0-100) Assistance activity Range (0-70) + Vitality of PC Movement Range (0-30) (+) A provisional proposal

  27. EAPC RANKING ON THE DEVELOPMENT OF PC (+) 100 UK (+) A provisional proposal

  28. CONCLUSION • Palliative Care around Austria is developed in several different grades. In some countries, an explosion of PC has been noticed very recently and, in the others, our informants are really optimistic about the future. • As a European citizen, I believe that the deep roots of this elder Europe have still power to send fresh sap, the sap of the movement of PC, to all those who need it in the 52 countries of our study.

  29. “The human quality of our society can be measured by how we care for people in the last time of their lives.There should be enough facilities for hospice care, for all those who need it.“Chancellor Dr. W. SCHÜSSEL 6th March 2003http://www.austria.gv.at/regierungserklaerung.pdf

  30. A Collaborative Effort The International Observa ry on End of Life Care (IOELC) • David Clark LIVERPOOL (UK) IOEL • Luis Alberto Flores VALLADOLID (SPAIN) EAPC Member • Javier Rocafort BADAJOZ (SPAIN) EAPC Member • Anthony Greenwood LIVERPOOL (UK) IOEL, Research Assistant • David Prail LONDON, (UK) HELP THE HOSPICES • Liliana de Lima HOUSTON (USA) IAHPC • Amelia Giordano MILAN (ITALY) EAPC Head Office • Silvia Paz BARCELONA, (SPAIN) EAPC Member • Tom Lynch LIVERPOOL (UK) Research Assistant • Carlos Centeno PAMPLONA, (SPAIN) EAPC Board, Chair 52 correspondent members: one in each countrry 30 Boards of Nationals Association With partial fiancncial support of...

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