On the day, 70 people from across the UK came together to discuss issues within Global Palliative Care.
Following the welcome by Prof Liz Grant from the Global Health Academy, who set the scene for the day, Dr Jane Bates from Malawi, talked about palliative care as a tool for poverty alleviation, sharing case studies from her experience in Malawi. She discussed ways in which palliative care contributes to reducing poverty, for example how managing pain could mean that either the patient themselves, or at least their caregiver, may be able to get back to work. She discussed the need for economists to be involved and to help us make the argument that by improving palliative care provision in low and middle income countries, we have an impact on poverty reduction.
Palliative care makes a difference regardless of setting, thus Sebastien Moine from France went on to discuss how primary palliative care can make a difference across Europe. He shared some of the work of the EAPC Primary Palliative Care Reference Group. He discussed some of the inequalities of care across Europe, with some countries having well developed primary palliative care, but others having limited access. The Reference group is currently looking at core competencies for primary palliative care, along with the best ways to spread the momentum for primary palliative care across Europe. He shared some of the recent literature showing disparities, particularly with regards to children’s palliative care and pain management.
One of the challenges globally at this time is that of humanitarian situations, whether that is natural disasters, illness or war. The provision of palliative care within this situation has not been seen as a priority, however the needs are great and there is ongoing work around the world in this area. As a result of advocacy in this area there is now the facility for countries to order immediate response packs which now contain morphine, however many countries are not doing this. Dr Mhoira Leng introduced PALCHASE (Palliative Care in Humanitarian Aid Situations and Emergencies), an initiative within palliative care to try and ensure the provision of palliative care in such situations, working with humanitarian agencies, to help build their capacity in this area.
Leadership training for nurses
Developing nurses in palliative care leadership is essential as nurses are often at the forefront of palliative care provision in many countries. Prof Julia Downing described a nurse leadership programme that has been conducted in Uganda – 20 palliative care nurses were trained in leadership, supported by mentors from the UK, funded by DFID through THET. The impact of the programme was discussed, describing some of the results of the evaluation of the programme, and listening to Edith, one of the nurse, from the Ugandan People’s Defence Force, describing what she learnt through the programme and how it has impacted her work, and her career, having been given more responsibility, and recognised as a key leader in palliative care within the Army. It is exciting to see the way that the leadership skills of the nurses have been recognised and many of them have been given more responsibility and have been given new opportunities within their organisation, in Uganda and internationally.
Integration into education programmes
Integration of palliative care within education programmes is essential and Prof Liz Grant shared the online Masters Programme in Family Medicine from the Global Health Academy, and the need and challenges to the integration of palliative care in this field. During the morning we also saw two videos, one of the work of EMMS International and the ICPCN and how individuals and organisations can get involved in Global Palliative Care.
In the afternoon there was much group discussion and sharing between participants, with an emphasis being placed on what resources and tools are needed to help support global palliative care and where these can be found. Dr Kirsty Boyd shared about the SPICT clinical tool and how this is being used in different parts of the world to help in the identification of patients that need palliative care.
Participants were asked to identify the different areas in which they would be happy to provide support for example, education and training, service evaluation, mentoring, leadership and curriculum design, in both children’s and adult palliative care.
Throughout the day there was a real enthusiasm for global palliative care and it was great to be able to meet new people and strengthen existing friendships.