Primary Palliative Care in Ireland – A
Collaborative Approach
Dr Paul Gregan , Dr Emer Loughrey , Marie Lynch , Dr Eve O’Toole
1
2
3
4
1 Blackrock Hospice & 22 Clonkeen Road; 2 Dr E Loughrey and Associates; 3 Irish Hospice Foundation, 4 National Cancer Control Programme
AIM: Primary Palliative Care in Ireland Phase 1
National steering group established (2010) to identify initiatives
in primary care to support the care of those in their last year of
life, with representatives from National GP Association, the HSE
and the Irish Hospice Foundation
CONTEXT
 Irish policy states SPC teams should provide support to community based HCP1
 Irish policy shifting emphasis to care in the community2
 Increasing ageing population living with advancing life limiting disease3
 No formal framework to support delivery of primary palliative care
RESEARCH THEMES
 Communication
 Education
 Information transfer
 Medication
 Non-Cancer
METHODS
• Community HCP (n=127) participated in 5 regional consultation meetings
• Postal questionnaires to 5 health regions - 26% response rate (N=180):
• Literature review
• Steering group with expertise provided oversight
• Primary Palliative Care in Ireland published 2011
‘Even
where diagnosis is
adequately explained there is a
need to be mindful of peoples
level of comprehensions people just hear one word and
shut down, are absolutely
terrified…’ PHN
‘I sometimes feel
inadequate and
unable to fulfil
my role properly
due to lack of
information from
hospitals’ GP
‘As a GP I would
like education on
how palliative
care services
would fit into the
care of noncancer patients’
CONCLUSION
KEY FINDINGS
90
80
70
60
50
40
30
20
10
0
GP n=50
Identify
target
patients
Medication
guidance
Education
symptom
mngmt
SPC
Advice
OOH
OOH
Handover
C Nursing n=73
NEXT STEPS
1. Primary care teams
acknowledge their role in
the delivery of palliative
care to patients with life
limiting disease in the
community
2. Key practical aspects of
service development have
been identified for further
action – see below
Primary Palliative Care in Ireland Phase 2
1. Develop and implement a palliative care summary for communication with out of hours
services
2. Create a system for primary care teams to identify patients with palliative care needs and
respond appropriately.
3. Clarify the extent and means of access to 24 hour SPC advice/information
4. Provision of information re the extent of palliative care available locally via the primary care
team/specialist palliative care
5. Provision of information on compatibility of syringe driver medications
6. Engage with professional groups to encourage role clarification and professional development
in this area
REFERENCES:
Department of health and Children 2001
HSE Service Plan 2011
CSO 2011
Further Information: Marie Lynch, Irish Hospice Foundation: marie.lynch@hospice-foundation.ie; IHF Website - Development Page: http://www.hospice-foundation.ie Sept 2012