Budapest Commitments: news from Poland

Wojciech Leppert, Chair and Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland. Continuing our series about the Budapest Commitments, Professor Leppert looks at how Poland is doing.

Professor Wojciech Leppert

Although Poland did not officially sign up to the Budapest Commitments in 2007, we have nonetheless used this initiative as a framework to develop palliative care in our country. This is how we have progressed in terms of: access to medication, education, quality and policy development.

Our National Scientific Conference, held last October in Wisla, was an important milestone in palliative care development in Poland. The conference marked the 10th Anniversary of the Polish Association of Palliative Medicine – in Polish Polskie Towarzystwo Medycyny Paliatywnej (PTMP)  – a 200-strong association for palliative medicine specialists in specialty training or physicians interested in palliative medicine. Under the patronage of the President of Poland, Bronislaw Komorowski, the conference was attended by the President Minister, Dr med. Maciej Pirog, and more than 300 participants from all over Poland.

Guest speakers from Poland and other countries explored recent palliative medicine developments. We were delighted that in her lecture, ‘Reflections on palliative care – yesterday, today and tomorrow’, Professor Sheila Payne, President of the EAPC and Director of the International Observatory on End of Life Care, commented that Poland had made significant progress in the development of palliative and hospice care in the past 20 years, emphasizing that nearly all resources for palliative care originated from the public sector (National Health Fund).

Other speakers from Europe included Dr Tony O’Brien (Ireland), who demonstrated problems associated with insufficient pain management in a global perspective, and Dr John Zeppetella (UK). Dr Zeppetella’s presentation included the management of breakthrough pain that he put into the context of the recent EAPC recommendations for the use of opioids in cancer pain patients.

Access to medications
Thanks to the support of the PTMP and the Polish Association for the Study of Pain, a new law was introduced on 30 December 2012 concerning opioid prescription. This means that prescriptions for all drugs, including opioids, are now written on normal white forms ending the old, stigmatising ‘pink receipts’ for opioids.

Policy, education and quality
More developments are planned by the Expert Group of the National Consultant of Palliative Medicine that worked as an Advisory Team to the Ministry of Health, including an increase in the number of beds and other resources in inpatient units, more posts for physicians during specialty training in palliative medicine, and improvement of under– and post–graduate education. It is also proposed to widen admission criteria for specialist palliative care by increasing the number of diseases, as currently only patients with cancer and a few other chronic diseases may be admitted to palliative care services.

PTMP will be setting up new standards for symptom management and psychosocial and spiritual support in palliative medicine. A recent development is the expansion of Palium Hospice in Poznan from 24 to 37 beds in the inpatient unit, which is due for completion in autumn 2013.

This year’s major conferences have already started: a large palliative care conference together with the assembly of The Polish Association of Nursing Palliative Care and a pilgrimage of Polish hospices to a Catholic monastery, Jasna Gora, was held in Czestochowa in January. In March, in Gdansk, an education conference of the journals, Medycyna Paliatywna w Praktyce and Advances in Palliative Medicine will be held. The next meeting, under the patronage of PTMP and the journal Medycyna Paliatywna is scheduled for April in Warsaw (‘Palliative Care in 2013’). Elsewhere, Poland will be doing its bit to support palliative care at the 13^th World Congress of the European Association for Palliative Care in Prague, followed by the MASCC/ISOO International Symposium on Supportive Care In Cancer in Berlin  at the end of June. Meanwhile, the Palliative Care Team from Wroclaw will be preparing for the 4^th PTMP Congress to be held in autumn 2014.

Find out more…
Click here to read how other national organisations have used the framework of the Budapest Commitments to develop palliative care.  All published material will be summarised by Dr David Oliver in his guest editorial in the May/June 2013 issue of the European Journal of Palliative Care and will be presented at the 13th World Congress of the European Association for Palliative Care in Prague 2013.