The vision of the Centre, as expressed by director, Dr Martin Loučka, is: “To improve the evidence base and knowledge about palliative care within the professional community and the general population.”
According to Dr Loučka, the centre represents a “crucial milestone” on the way to advance the evidence base of palliative care in the Czech Republic, to educate clinicians and the Czech public, and to bring more insight from Eastern Europe into the discussion about palliative care within the European community.
A special symposium marked the opening of the Centre and the venue was filled by academics from different universities in Germany, Slovakia, the UK and the Czech Republic, as well as physicians and hospice care providers from all around the country.
Professor Sheila Payne, the president of the European Association of Palliative Care (EAPC), Professor Claudia Bausewein, head of the palliative care clinic at University Hospital in Munich, and Dr Ondrej Slama, research secretary of the Czech Society of Palliative Medicine were there to show their support and to give “inspiring” presentations.
Although there is a relatively well-developed network of inpatient hospices throughout the Czech Republic, palliative care is not well integrated within hospital settings. There are only three palliative care units in the whole country and, according to Dr Loučka, referring patients to palliative care is “a significant barrier”.
There is also a great need for public education on the subject. A representative survey, conducted in 2013, showed that more than three quarters (79%) of Czech people did not understand the term ‘palliative care’ and did not differentiate between hospice and hospital in terms of preferred place of death (9% indicated hospice as the preferred place of death vs 11% for hospital).
Education in palliative care is not included in the curriculum for medical or nursing students, with only three out of 8 medical schools in the country offering some – optional – courses in palliative medicine.
Dr Loučka said: “We can say that palliative care in the Czech Republic is currently undergoing a transitional phase between the initial stage – illustrated by establishing inpatient hospices, which were usually founded by enthusiastic pioneers without much recognition from the official institutions – and a more integrated stage, which brings opportunities for expanding palliative care outside the walls of inpatient units.
“However, this step sets new challenges for the palliative care community, such as the need for an evidence base to explain the benefits of palliative care to other professionals, service providers and decision makers, and the essential importance of finding the language which will be understandable and acceptable for the public (to communicate about palliative care). I believe that our Centre will help to find the right answers to these challenges.”
The ‘turning point’
The idea for the Centre had been brewing in many people’s minds, but it took a meeting at the EAPC congress in Prague in 2013 to start the project. Dr Loučka met with Dr Slama and Mr Marek Uhlir, director of Cesta domu – a Prague-based mobile hospice care service – to discuss the idea. Dr Loučka said: “I do not remember who was the first person actually proposing the idea, but we all shared the vision of a research organization which would help the palliative care movement in the Czech Republic to grow.”
The crucial turning point, which made the whole idea real, came when the AVAST foundation announced their new funding scheme focused on palliative care. The foundation supports the field of palliative and end of life care through a special funding scheme called: ‘Together until the End’. The AVAST foundation supported 11 new projects in 2014, including the Centre which was established by the gift of 1 million CZK.
Dr Loučka explained how the Centre was chosen, saying: “We submitted the project of the Centre and found that it was an ideal match with the priorities of the foundation. With their support we could finally start bringing the ideas from paper to reality.”
As well as being a world-class research institute its own right, researchers from the Centre collaborate closely with the Department of Oncology of the 1st Faculty of Medicine at Charles University (ESMO accredited integrated centre for palliative care and oncology) and Cesta domu for research projects and educational activities.
The Centre has three main areas of activity: Research, education and public campaigns.
For one of the Centre’s latest research projects, the staff is preparing a study of integrated palliative care within the department of oncology at the general teaching hospital in Prague, which would explore the possibilities of closer cooperation between hospice and hospital care providers.
The Centre organises monthly seminars which are broadcasted online to make them more accessible for people who can’t travel to Prague just for the seminar. They also provide tailored courses, one example being training for Primary school teachers who often have to deal with death in families of their students.
These are aimed at improving the knowledge about palliative care in the general population. Dr Loučka has served as a consultant for an original web-based campaign: Moje Smrt (My Death), focused on thinking about and preparing for death. It has attracted attention from the media and the public. The Centre is currently preparing an English version of the campaign to be available for people across Europe.
Although the centre is just a few weeks old, with only two staff members and three Trustees, they are preparing a number of job opportunities for future colleagues, and the first two PhD researchers will start their projects in early 2015.
The Centre is also looking to expand their network of partner institutions. Dr Loučka said: “We cordially welcome any collaboration with other institutions in Europe and worldwide which share the vision of evidence based palliative care.”
As for the future, apart from research and educational activities, staff at the Centre are working on developing a strategic model of collaboration with Prague’s Charles University. Dr Loučka said: “Although being an independent organization gives some benefits and flexibility, it would be great if the centre was an official part of the university. As we have received support from a number of senior academics so far, I believe that this aim will be achieved in a not very distant future.”