A Baseline Study on the Provision of Hospice/Specialist Palliative Care Services in Ireland

Mar 1, 2006
The aims and objectives of this baseline study on the provision of Hospice/Specialist Palliative care service in Ireland were to present and up-to-date overview of the current state of service provision in hospice/specialist palliative care on a consistent basis regionally as well as providing a solid basis for assessing current and future service needs and for determining the resources required. There were specific gaps in service provision relative to the recommendations of the National Advisory Committee on Palliative Care (Department of Health and Children, 2001).

This evidence base proved to be a useful advocacy tool for advocates and providers of palliative care in Ireland.

The research study as a source of evidence has been a very useful advocacy tool in raising awareness about the provision of hospice/specialist palliative care and influencing government with regard to palliative care provision.

The study found a wide regional divergence in the range of services and care options available. And while a notable expansion in the number of consultants in palliative medicine appointed, in many cases these were not accompanied by an expansion of hospital-based teams. The study also revealed a significant shortfall in government funding and a consequent lack of progress in the development of specialist palliative care services. In general, it might be said of the 'state of the field' that there are certainly signs of movement in the direction of stated government policy since 2001. However, the pace of change has been hugely varied.
  • Four years after the publication of the Report of the National Advisory Committee on Palliative Care, many of its recommendations remain unfulfilled
  • Increases in population, coupled with new life-prolonging treatments, will together lead to an increase in demand for palliative care services.
  • The percentage of people over the age of 65 will rise from 11% in 2002 to 13% in 2016, an increase of 195,000 people.
  • Over 29,000 deaths occurred in 2002, with 25.6% being due to cancer. An estimated 70% of cancer patients with advanced disease and 20% of non-cancer patients require access to palliative care services.
  • In areas where palliative services are more developed, there is an increased incidence of death in a hospice/palliative care inpatient unit or home setting, as opposed to places with underdeveloped services which see more people die in acute general hospitals.
  • The NACPC report recommended 8-10 inpatient beds. X Acute general hospitals are the main source of referral of terminally ill patients to hospice and palliative care services. X It is government policy that all acture general hospitals with over 150 beds should have a full, consultant-led palliative care team. Only 8 out of 38 of these hospitals were in compliance -- 12 had a partial team, 7 had a nurse-only team, and 11 had either no service or depended on external support from community-based teams.
  • State funding for home care services varies from location to location from 100% to 0%.
  • Non-cancer patients do not have the same access to night nursing services as those with advanced cancer.
  • Patient and family access to comprehensive services largely depends on the region of the country in which the patient resides.
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