Primary Palliative Care in Ireland - Taking Direction from EAPC Toolkit

CONCLUSION Ireland has made some progress in responding palliative care needs of those living in the community, that meet with guidance from the EAPC toolkit.

Further progress is required particularly in the area of implementation frameworks, to support systematic and co-ordinated delivery of care to patients with palliative care needs.

Authors: M Lynch, IHF; T Duffy, IHF; P Gregan, Blackrock Hospice & GP; Scott Murray, University of Edinburgh; C Hayden, OLH

For more information: marie.lynch@hospicefoundation.ie Feb 2014

The EAPC Toolkit (2013) was developed to guide palliative care services in primary care in Europe. The recognition that access to palliative care is a human right underpins this work. The toolkit is based on the 4 domains of WHO public health strategy for palliative care:

Policy, Education, Drug Availability and Implementation

The IHF/ICGP/HSE Primary Palliative Care in Ireland report recommended improvements in community to support those in their last year of life (2011)

This poster synthesises the key information in the EAPC toolkit and compares with the Irish Primary Palliative Care initiatives

POLICY The EAPC recognises the Primary Palliative Care in Ireland

report as a means of supporting palliative care in the community

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DRUG AVAILABILITY Below summarises how Ireland addresses the 5 EAPC action points : 1. Formulary restrictions – 6 items on essential medicines are not available 2. Regulatory restrictions – no restrictions on opioids prescribed by doctors 3. Emergency prescribing –no legal provision for emergency prescription 4. Special prescription forms - these are required for two types of medications 5. Dispensing – Legally pharmacists cannot make technical changes to prescriptions

EDUCATION The EAPC welcome education efforts reduce barriers

to discuss death dying and bereavement; The ICGP Certificate in Palliative Care and AIIHPC, HSE, IHF and IAPC Palliative Care competence framework are examples of how Irish initiatives

IMPLEMENTATION FRAMEWORKS The EAPC toolkit identified

6 approaches to support palliative care in the community – GSF, SPCIT, NHS Quick Guide (UK); RADPAC (Netherlands); NECPAL (Spain); Rainone (USA)

NONE of these are in use in Ireland

WHO public health strategy 2007