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PALLIATIVE CARE FOR ALL. Integrating Palliative Care into Disease Management Frameworks – HSE (The Health Service Executive) i IHF (Irish Hospice Foundation) 2008

Definitions s. 12

Level one – palliative care approach

Palliative care principles should be practiced by all health care professionals. The palliative care approach should be a core skill of every clinician at hospital and community level. Many patients with progressive and advanced disease will have their care needs met comprehensively and satisfactorily without referral to specialist palliative care units or personnel. The palliative care approach aims to promote both physical and psychosocial well-being. It is a vital and integral part of all clinical practice, whatever the illness or its stage, informed by a knowledge and practice of palliative care principles [1].

Level two – general palliative care

At an intermediate level, a proportion of patients and families will benefit from the expertise of health care professionals who, although not engaged full time in palliative care, have had some additional training and experience in palliative care, perhaps to diploma level. Such intermediate level expertise may be available in hospital or community settings [1].

Level three – specialist palliative care

Specialist palliative care (SPC) services are those services whose core activity is limited to the provision of palliative care. These services are involved in the care of patients with more complex and demanding care needs, and consequently, require a greater degree of training, staff and other resources. SPC services, because of the nature of the needs they are designed to meet, are analogous to secondary or tertiary health care services. SPC services are those services with palliative care as their core speciality and which are provided by an inter-disciplinary team, under the direction of a consultant physician in palliative medicine. SPC services are available within primary care settings, acute general hospital settings and specialist inpatient units [1].

Access to Specialist Palliative Care for People with Non-Malignant Diseases

(…) Experience from the UK suggests that it can be beneficial to phase the introduction of a wider availability of SPC services, building up the services once experience is gained. This would assist in addressing the supplementary training and education needs identified by SPC to deal with this population. Additional training is also required by the disease-specific specialties to identify and respond to non-specialist palliative care needs of their patients.