EAPC TASK FORCE IN PRIMARY PALLIATIVE CARE (2015)

A multi-disciplinary EAPC Task Force was established in  2012 to scope the extent of and learn what facilitates and hinders the development of palliative care in the community across Europe.   

Aim 

To document the barriers and facilitators for palliative care in the community; and to produce a resource toolkit that enthusiasts could use to facilitate the development of palliative care in different countries throughout Europe and possibly worldwide.      

Design   

• Step 1: A survey instrument was sent to general practitioners with knowledge of palliative care services in the community in a purposefully diverse sample of European countries in 2012.  Barriers and facilitating factors relating to providing community palliative care were identified and analysed.  
• Step 2: A draft toolkit was then constructed suggesting how individual countries might best address these issues and an online survey was then set up for general practitioners and specialists to comment on and develop the toolkit. Iterations of the toolkit were then presented at international palliative care and primary care conferences. 

An international systematic review of tools used to identify people for palliative care in the   community was also conducted. 

Results 

A toolkit has been produced and refined, together with associated guidance, to help primary care and specialist palliative care leaders throughout Europe advocate for and develop palliative care in the community, “primary palliative care�?. 

  
Conclusions 

The four domains of the WHO Public Health Strategy provided a robust framework to collate the resources and structure the toolkit.  The task force toolkit usefully supplements previous work to help community based palliative care services to be established to ensure adequate population coverage.   

What is already known 

Most patients die before accessing either specialist or generalist palliative care 
For palliative care to be accessible to all in need it must be available in the community  

What this  adds 

• Palliative care in the community is under-developed in many European countries 
• A toolkit is now available to facilitate the development of palliative care in the community in different countries throughout Europe and the world  

Implications for practice theory or policy 

• National strategies should be drawn up to develop policies, education, implementation strategies, and drug availability in the community. 
• The toolkit outlines the steps that can be taken depending on the current stage of development in each country or region