Scott A Murray, co-chair, Libby Sallnow, secretary, and Hélder Aguiar, member, the EAPC Taskforce on Primary Palliative Care
This taskforce seeks to understand and develop the practice of palliative care in primary care throughout Europe. Its first meeting was held in Vic (Barcelona) during Catalonia’s Association of Palliative Care 9th congress. This was a special event to commemorate the beginning of palliative care in Spain, which was started in Vic, Barcelona, 25 years ago by Professor Xavier Gómez-Batiste.
Barriers to primary palliative care
During this event, the taskforce reviewed its initial findings of a study that aims to identify the models, policies, facilitators and barriers for primary palliative care across countries in Europe. Significant differences were found in models of palliative care, especially in the number and types of services, but there was a convergence in the perceived barriers for primary palliative care. These included lack of training, resources, funding and time; bureaucracy issues (including lack of morphine prescribing in some areas) and lack of coordination between generalist and specialist services. Most countries lack registers and frameworks directed to palliative patients.
While there is evidence that primary care is an essential key for the development of an earlier, more accessible and wider palliative care, there is still much to be done in order to let more people in Europe benefit from it. The potential role for this taskforce in addressing these complex issues was explored: by establishing ways to help develop the practice of palliative care in primary care. Hopefully, this collaboration will result in the elaboration of guidelines and links between specialist and primary palliative care, and documents to be used in advocacy. The taskforce members present in Vic were Scott Murray (Scotland), Eric Van Risjwijk (Holland), Xavier Gómes-Batiste (Spain), Trine Brogaard (Denmark) and Hélder Aguiar (Portugal).
Planning the survey – can you help?
The taskforce met again at the UK Palliative Care Congress in Newcastle on 16 March where other members from Germany, Belgium, Serbia, England and Ireland further discussed and planned how the survey of palliative care in the community in European countries could be speedily completed, before the e-Delphi process is started to gain a consensus around recommendations. We would be delighted to receive any advice or information from anyone at this stage, especially about the actual or potential role of primary care in delivering palliative care in your own country.
About the authors
Professor Scott Murray is Chair of Primary Palliative Care at the University of Edinburgh. Scott leads a multi-disciplinary team highly successful in researching the experiences of patients with life limiting illnesses and their carers, and in developing and testing models of holistic care throughout the last year of life. Dr Libby Sallnow is the Research Fellow at St Joseph’s Hospice, London and is undertaking a PhD at the University of Edinburgh in a public health approach to end of life care. She is also a member of the Primary Palliative Care Research Group. Both are involved in international palliative care projects: Scott in Africa where he conducts training, evaluation and research, and Libby in India where she is the honorary Research Fellow at the Institute of Palliative Medicine, Calicut, Kerala. Hélder Aguiar is a palliative care MSc student at King’s College London and a GP trainee in Portugal, where he is developing a project for identifying the effectiveness of a Portuguese home palliative care team model.