EAPC Atlas of Palliative Care in Europe 2019
Conclusion: PC health policies developed in recent years have promoted vigorous development across Europe. Preliminary data on the integration of PC into different fields are encouraging though inequalities between countries and sub-regions persist. Further comparative analysis exploring factors leading to uneven progress may inform strategies to provide PC for all people in need. Per land is de stand van zaken van de (kinder)palliatieve zorg weergegeven.
Conclusion: PC health policies developed in recent years have promoted vigorous development across Europe. Preliminary data on the integration of PC into different fields are encouraging though inequalities between countries and sub-regions persist. Further comparative analysis exploring factors leading to uneven progress may inform strategies to provide PC for all people in need.
Per land is de stand van zaken van de (kinder)palliatieve zorg weergegeven.
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LONG-TERM CARE FACILITIES<br />
B<br />
COLLABORATION BETWEEN PC TEAMS<br />
AND LTCFs STAFF (EXPERTS’ ESTIMATION)<br />
COUNTRY Collaboration frequency BETWEEN TEAMS<br />
Kyrgyzstan<br />
Lithuania<br />
Austria<br />
Belgium<br />
Denmark<br />
France<br />
Germany<br />
Greece<br />
Poland<br />
Spa<strong>in</strong><br />
Switzerland<br />
The Netherlands<br />
UK<br />
Czech Republic<br />
Israel<br />
Italy<br />
Russia<br />
Armenia<br />
l Allways<br />
l Most <strong>of</strong> the times<br />
l Sometimnes<br />
l Very rarely<br />
l Never<br />
FUNDING FOR PC PROVISION IN LTCFs<br />
Armenia, Austria, Belgium, Czech Republic, France, Germany,<br />
Italy, Kyrgyzstan, Lithuania, Russia, The Netherlands, United<br />
K<strong>in</strong>gdom report some sort <strong>of</strong> fund<strong>in</strong>g for palliative care provision<br />
<strong>in</strong> Long Term <strong>Care</strong> Facilities.<br />
research ON PC PROVISION AT LTCFs<br />
Country P R<br />
Armenia<br />
Austria<br />
Belgium<br />
Czech Republic<br />
Denmark<br />
France<br />
Germany<br />
Greece<br />
Israel<br />
P: Publications on PC provision<br />
R: Involvement <strong>in</strong> <strong>in</strong>ternational research projects<br />
No l Yes N/S<br />
Country P R<br />
Italy<br />
Kyrgyzstan<br />
Lithuania<br />
Poland<br />
Russia<br />
Spa<strong>in</strong><br />
Switzerland<br />
The Netherlands<br />
UK<br />
RELEVANT KEY NOTES<br />
Country<br />
KEY NOTES<br />
Country<br />
KEY NOTES<br />
Belgium<br />
Czech Republic<br />
Denmark<br />
Belgium has a Law regulat<strong>in</strong>g the ‘PC function’ for LTCFs<br />
and for regulat<strong>in</strong>g the responsibility to provide PC.<br />
The long-term palliative care is still neglected <strong>in</strong> Czech<br />
Republic. Currently, the attention is focused on mobile<br />
palliative care and paediatric palliative care.<br />
In Denmark, the LTCF manager is responsible for provid<strong>in</strong>g<br />
key competencies and tra<strong>in</strong><strong>in</strong>g <strong>in</strong> PC <strong>of</strong> the staff.<br />
Kyrgyzstan<br />
Poland<br />
The Cl<strong>in</strong>ical guidel<strong>in</strong>es and cl<strong>in</strong>ical protocol “Chronic pa<strong>in</strong>”<br />
on the basis <strong>of</strong> WHO recommendations were approved by<br />
the M<strong>in</strong>istry <strong>of</strong> Health <strong>of</strong> the Kyrgyz Republic <strong>in</strong> 2013.<br />
In Poland there are general standards <strong>of</strong> PC, but they<br />
are not specific and adjusted to long term care. Specialist<br />
PC services by-law are excluded from LTCFs. If a<br />
patient is referred to LTCFs cannot receive PC from the<br />
specialists <strong>of</strong> this field.<br />
France<br />
France has guidel<strong>in</strong>es focused <strong>in</strong> end-<strong>of</strong>-life care, specifically<br />
<strong>in</strong> nurs<strong>in</strong>g homes. They have been published <strong>in</strong><br />
November 2017 by the French national agency for the<br />
assessment and the quality <strong>of</strong> social and health care<br />
services (ANESM), which is now part <strong>of</strong> the National<br />
Authority for Health (HAS).<br />
Spa<strong>in</strong><br />
In Spa<strong>in</strong> there is no specific documents about PC and<br />
LTCFs. However, some PC documents refer the necessity<br />
to provide attention to these <strong>in</strong>stitutions. The fact<br />
that Spa<strong>in</strong> is divided <strong>in</strong>to autonomous communities<br />
with <strong>in</strong>dependent health policies and laws, makes difficult<br />
standardized these two levels <strong>of</strong> care.<br />
Greece<br />
Italy<br />
The National Strategic Plan for develop<strong>in</strong>g and implement<strong>in</strong>g<br />
PC <strong>in</strong> Greece is currently be<strong>in</strong>g elaborated.<br />
Mapp<strong>in</strong>g <strong>of</strong> exist<strong>in</strong>g services did not reveal long-term<br />
facilities provid<strong>in</strong>g PC.<br />
In 2012, the National M<strong>in</strong>istry <strong>of</strong> Health and State-Regions<br />
Conference <strong>of</strong> Italy def<strong>in</strong>ed an agreement on the<br />
def<strong>in</strong>ition <strong>of</strong> <strong>Palliative</strong> <strong>Care</strong> Local Network. This def<strong>in</strong>ition<br />
is only an agreement among National Government<br />
and Regional Governments, because standards <strong>of</strong><br />
quality provision <strong>of</strong> palliative care <strong>in</strong> LTCF are def<strong>in</strong>ed by<br />
every Regional Government.<br />
Switzerland<br />
The Netherlands<br />
UK<br />
In Switzerland, each canton has his all legislation and<br />
regulation on these issues.<br />
A large part <strong>of</strong> LTCFs <strong>in</strong> The Netherlands have an Elderly<br />
<strong>Care</strong> Physician extra specialized <strong>in</strong> PC (“kaderarts<br />
palliatieve zorg”), <strong>of</strong>ten part <strong>of</strong> a PC team. Several<br />
LTCFs have palliative care units with tra<strong>in</strong>ed staff.<br />
There are no regulat<strong>in</strong>g bodies for PC <strong>in</strong> LTCFs <strong>in</strong> UK. The<br />
ma<strong>in</strong> national document that <strong>in</strong>cluded LTCFs was published<br />
<strong>in</strong> 2008 ‘End <strong>of</strong> Life <strong>Care</strong> Strategy’. There are a<br />
number <strong>of</strong> other national projects (…) and advance care<br />
plann<strong>in</strong>g policies that are <strong>in</strong>corporated <strong>in</strong>to care homes.<br />
<strong>EAPC</strong> <strong>Atlas</strong> <strong>of</strong> <strong>Palliative</strong> <strong>Care</strong> <strong>in</strong> <strong>Europe</strong><br />
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