Katalin Hegedus PhD, Deputy Director, Associate Professor, Semmelweis University, Institute of Behavioural Sciences, Budapest, and Agnes Csikos MD PhD, Associate Professor, University of Pecs Medical School, Institute of Family Medicine, Department of Hospice-Palliative Care, Pecs, Hungary
During the 2007 EAPC congress held in Budapest, Hungary, a two-year campaign was launched with the national palliative care associations to develop strategies at country level. The campaign included commitments to accomplish goals within a proposed framework. This project was called the Budapest Commitments.
The Budapest Commitments were good opportunities for us to formalise the main problems and to develop strategies to resolve these problems. In Hungary, we announced the following commitments:
- to develop quality care, strengthen multidisciplinarity in the care, and specify the role of physicians in the team;
- to improve the palliative education of physicians;
- to establish an inpatient palliative service in a university hospital.
So what have we achieved in the past five years to fulfil the Budapest Commitments?
Quality improvement measures
Since 2008, we have updated quality protocols, special criteria and quality control in collaboration with the Ministry of Health and the National Health Insurance Service (2010, 2012). These protocols helped us to specify the role of physicians within the palliative team. With the help of the National Health Council, we updated and supervised the implementation of the National Cancer Control Program especially in regard to the development of palliative care (2010).
In spring 2012, we updated the minimum criteria to provide hospice-palliative care and Hungarian law now regulates four types of care: home care, inpatient hospice-palliative care, inpatient consultation service and outpatient care. Paediatric hospice-palliative care minimum criteria have also been regulated.
University hospital-based palliative care
In 2012, the first university hospital palliative outpatient service started to see patients at Pecs, in the Institute of Oncology.
Development of specialist medical education and training
Palliative medicine as a sub-speciality for physicians is imminent in 2012. The first academic centre of palliative care, the Department of Hospice-Palliative Medicine, was established in summer 2012 at Pecs University Medical School. The department works collaboratively with other medical schools, the Hungarian Hospice-Palliative Association and hospice care providers. One of the main goals of the department is to develop and enhance the national medical curricula at undergraduate and postgraduate level and sub-specialist training. From autumn 2012, all junior doctors/residents in compulsory specialist training programmes will undertake a 40-hour palliative care education programme.
But while we have achieved many of our goals there is still much to do and we must put more emphasis on:
- the development of education across the country – both at professional and public / community level
- the development of quality control measures
- the development of national and international research programmes.
The challenges and tasks continue as we look forward to ensure that palliative care is recognised more widely in the future.
To find out more…
Click here to find out more about Hungarian hospice-palliative care.
Share your story…
We’d like to hear how other national organisations are implementing the goals they set themselves back in 2007. Dr David Oliver (UK) and Dr Michaela Bercowitz (Israel), board members of the EAPC, are currently collating information about the Budapest Commitments and urgently need your help. Information is for eventual publication, including this blog, and for the 13th World Congress of the European Association for Palliative Care in Prague. To contribute, or for more information, please contact Dr David Oliver.
COMING UP… Please follow the blog and find out how Switzerland has kept its promise to the Budapest Commitments. And in the coming weeks we hope to hear from many more countries.