International perspectives on improving end of life care

Scott MurrayProfessor Scott A Murray is the St Columba’s Hospice Chair of Primary Palliative Care Research Group at The University of Edinburgh in Scotland, UK

 

We live in exciting times for palliative care in general and for palliative care in primary care and family medicine in particular. The World Health Assembly (WHO's resolution-making body) in May 2014 passed its first ever resolution about palliative care. It called for palliative care to be integrated into health care in all settings, especially in the community, and countries will be answerable to this resolution in May20161.

Ten years ago Professor Geoff Mitchell, a speaker in today's NAPCRG 2015 plenary session, and I decided on his patio, one warm evening in Brisbane, Australia, that it was high time to re-emphasise the potential of palliative care in the community. That night the International Primary Palliative Care Network was born. We then invited Fred, another of today's speakers, from Halifax, Nova Scotia and a few other family physicians prominent in this area and the rest is history!

Our enthusiastic band has grown over the years, meeting at palliative care and also primary care conferences to develop the strategic interface between the two. We highlight the great potential of staff working in the community to provide holistic care to people with all illness, early in the illness, and covering all dimensions of need. Now we have members in more than 40 countries in every continent and have, as a group, published articles encouraging countries from Singapore to Germany to Lebanon to develop primary palliative care.

We recently were tasked by the European Association for Palliative Care (EAPC) to produce a toolkit to facilitate the development of palliative care in the community. The World Organization of Family Physicians (WONCA) has endorsed the toolkit, and highlighted it at the World Health Assembly in May 2014 as a means whereby palliative care can be integrated into primary health care.

This toolkit will help support individuals and organisations worldwide seeking to further develop palliative care services in primary care settings. Copies of the short toolkit in English, French and German are available to download (see also 'useful resources' links below). The toolkit comes with many active web links to documents which detail various helpful national policies, practices, and tools (such as the Supportive & Palliative Care Indicators Tool, SPICT™) so that patients can be identified for palliative care (and then be assessed and cared for). Countries can learn from what has worked well previously in other similar countries to fast-forward palliative care in their communities. The SPICT was downloaded 1200 times in August!

The current strong WHO advocacy for palliative care and this practical toolkit should greatly help many of us to develop palliative care in the community. Do contact Geoff or Fred at NAPCRG 2015 if you would like any advice or support, and please also join our International Primary Palliative Care Network (see links below). Although palliative medicine is now a specialty in America, it is we generalists who must be the troops so that good holistic care at the end of life reaches everyone.

Links and resources

This blog is one of a series from the 43rd North American Primary Care Research Group (NAPCRG) Annual Meeting, which runs from October 24-28, 2015, in Mexico. CMAJ is one of the sponsors of the meeting.

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