The conference, held alongside World Hospice and Palliative Care Day, was attended by more than 350 people from across the country, including representatives of the newly established palliative care units, directors of hospitals and primary health care institutions, along with officials from the Ministry of Health, the European Union, the Ministry of Social Welfare, the Health Insurance Fund and the Institute of Public Health.
The EU-funded project: ‘Development of Palliative Care Services in the Republic of Serbia’ has been implemented by Oxford Policy Management (OPM) and its consortium partners, BELhospice, GVG, Hospice Casa Sperantei and Hospices of Hope.
The project aimed to support the Ministry of Health to develop a comprehensive and modern system of palliative care in Serbia, accessible to all patients who require such care by providing technical assistance to help operationalise the national Palliative Care Strategy, adopted by the MoH in 2009.
Participants were welcomed to the conference by the Project Team Leader, Professor Julia Downing, who noted the ongoing developments of palliative care in Serbia. Professor Sazdanovic, Assistant Minister for Health, talked about the need for palliative care in Serbia, the progress made and the commitment of the Ministry of Health to the ongoing development of Palliative Care.
Yolanda san Jose, Head of the Operations Department of the EU Delegation praised all involved in the project for their achievements and the fact that palliative care is now more accessible to those who need it, whilst noting the ongoing need for development of palliative care within the country.
Following an overview of the key achievements of the project by Prof Downing, participants then had the opportunity to listen to two international guest speakers. Firstly Professor Sheila Payne, from the International Observatory on End of Life Care, Lancaster University, and President of EAPC, discussed European developments in palliative care and the role of the EAPC. She invited participants to be active members of the EAPC and noted that it would be great to have individuals from Serbia on the different task forces and Board.
A global perspective was then shared by Professor Scott Murray from Edinburgh University. He encouraged participants to think of 5 key challenges for palliative care provision – that it should be for: (1) all illnesses; (2) across the continuum of care; (3) for all dimensions of need; (4) in all settings and (5) for all nations.
Members of the project team then shared some of the different aspects of the project, including a presentation on continuing and academic education by Dr Natasa Milicevic and Professor Vesna Bosnjak; a presentation on implementation of palliative care by Dr Erna Haraldsdottor, and the model of palliative care service delivery by Prof Downing. Much has been achieved in the development of palliative care since the project started in 2010. Key achievements include:
- Model of Palliative Care – a model of palliative care service delivery has been developed for Serbia, along with a resource plan, quality indicators, standards of care, instruments and best practice guidelines.
- Palliative Care Units – 15 palliative care units, whose reconstruction was funded by the Ministry of Health, opened across Serbia.
- Legislation – Amendments to the Health Care Law, introducing a new form of health care provider called ‘palliative care centres’ had been officially accepted by the Government and are waiting for approval by Parliament. Changes to secondary legislation were proposed, and changes made to the positive list to ensure that essential medicines for palliative care are more widely available and accessible.
- Academic Curricula – palliative care has been developed and included in the curriculum for medical, nursing and social work students.
- Continuing Education – more than 1,200 employees in health and social care have been trained in palliative care.
- Publications – 4 key publications have been developed and published in Serbian: Palliative Medicine Handbook, Children’s Palliative Care Handbook, Model of Palliative Care Service Delivery and the Best Practice Guidelines.
A small appraisal of the impact of the project has been undertaken and initial results were shared by Dr Jo Hockley. Stakeholders reported change in practice, attitude and skills as a result of undertaking the training, and there was clear evidence that the project has significantly impacted the development of palliative care in Serbia.
The next steps were presented by Prof Downing, who challenged participants to keep up the momentum for the ongoing development of palliative care, to work together and to continue on towards the vision of palliative care for all in need in Serbia.
However, the final word went to some of the participants themselves through the premier of a film highlighting key achievements and showing the impact of the palliative care units on the patients and their families.
One patient spoke of the palliative care unit in Cacak where he was receiving care. He said: “I feel comfortable, I feel great, like I don’t have cancer. Here, they talk to me… just a few words are sufficient, nothing more.”
The words of the Head Nurse from the Palliative Care Unit in Cuprija, Vojislava Stanojevic, brought home the impact of the development of such units. She said: “The unit provides support to families and patients… now we have our patients who receive all the care, support, and can talk to us… a smile that we get from the patient, it is something that cannot be measured.”