Council of Europe Report of the Committee of Experts on the Organisation of Palliative Care

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Council of EuropeReport of the Committee of
Expertson theOrganisation of Palliative Care

• Adopted by the Committee of Ministers
• June, 2003
• Dr. Tony OBrien, Chairperson

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Council of Europe

• Right to health care aimed at achieving highest
  possible sense of well-being
• Growing need for palliative care
• Differences in availability and quality of
  palliative care throughout Europe
• Goal of palliative care is best possible quality
  of life ---

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Participants

• Dr. H. Retschitzegger (Aus)
• Mr. F. Mabrouk (Bel)
• Dr. Zdenek Bystricky (Cze)
• Dr. K. Holli (Fin)
• Dr. K. Hegedus (Hun)
• Dr. T. OBrien (Irl) Chair
• Mrs. D. Da Col (Italy)
• Dr. A. Diniz (Port)
• Mrs. M. Murg (Rom)
• Mrs. M. Godova (Slov)

• Dr. X. Gomez Batiste (Sp)
• Mrs S. Sauter (Swe)
• Dr. C. J. Furst (Swe)
• Dr. C. Mazzocato (Swit)
• Mr. M. Wright (U.K.)
• Prof. D. Clark (U.K.)
• Dr. K. Bernard (WHO)
• Fr. A. Brusco (Holy See)
• Mr. M. Chausson (EAPC)
• Dr. D. Willems (Nl) Cons.

Dr. Piotr Mierzewski, COE Secretariat
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Recommendations
Appendix
Explanatory Memorandum Glossary References
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Key recommendation 1
Adopt policies, legislative and other measures
necessary for a coherent and comprehensive
national policy framework for palliative care.
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Key recommendation 2
Take to this end, whenever feasible, the measures
presented in the appendix to the recommendation,
taking account of their respective national
circumstances.
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Key recommendation 3
Promote international networking between
organisations, research institutions and other
agencies that are active in the palliative care
field.
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Key recommendations 4
Support an active, targeted dissemination of
these recommendations and its explanatory
memorandum
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1. Palliative Care
.. is an approach that improves the quality of
life of patients and their families facing the
problems associated with life-threatening
illness, through the prevention and relief of
suffering by means of early identification and
impeccable assessment and treatment of pain and
other problems, physical, psychosocial and
spiritual.
W.H.O. 2002

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2. Palliative care principles

• Vital and integral part of health services
• Access care in a place, and at a time that is
  consistent with individuals needs and wishes
• Quality of life
• Whole person care
• Interdisciplinary teamwork
• All therapeutic options, as appropriate

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2. Palliative care principles

• Access based on need
• Education for all health care personnel
• Research focusing on quality of life
• Adequate and equitable level of funding
• Ethical issues in palliative care

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3. Settings and services

• Integrated programme in all care settings
• Interdisciplinary and multiprofessional
• Support for family carers
• Respite care
• Financial issues
• Leadership / coordination of care

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4. Policy and organisation

• Integral part of health care system
• Needs assessment studies
• Palliative care strategies
• Identify and address barriers to good palliative
  care
• Opioid availability legislation?
• Equity in access?
• Data collection

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5. Quality improvement and research

• Quality measures (multidimensional)
• Clinical practice guidelines
• Audit programmes
• Qualitative and quantitative research
• Collaborative research
• Observatory to collect, process and disseminate
  information.

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6. Education and training

• Academic posts
• Undergraduate curriculum for all health care
  professionals
• Specific post graduate programmes
• International cooperation
• Multidisciplinary learning
• General public
• Challenge negative attitudes, e.g. opioids

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7. Family issues

• Addressing family needs
• Family is unit of care
• All those significant in the life of the patient
• Emotional support
• Practical support

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8. Communication

• Essential aspect of health care provision
• Encourage honesty and openness
• Respect patients wishes
• Cultural influences
• Special needs groups e.g. children
• Not simply information exchange!

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8. Communication

• Communication skills training
• Hospital / hospice design issues
• Dedicated time for family meetings
• Access to modern IT facilities
• Case conferences

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9. Teamwork

• Interdisciplinary, multiprofessional
• Decision making?
• Volunteers
• Building and maintaining teams
• Information exchange
• Communication
• Individual Team support mechanisms

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10. Bereavement

• Loss is a universal human experience
• Bereavement care begins at the moment of first
  contact with patient / family
• Not an illness, do not medicalise response
• Levels of bereavement support
• ? Role of volunteers in bereavement support

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Council of Europe Report
Adopted by the European Health Committee in June
2003.