Midlands region is a “blackspot” when it comes to end of life and palliative care services

Categories: Community Engagement.

The Irish Hospice Foundation (IHF) has called for “urgent” action at government and HSE level to provide adequate end of life care services in Laois, Offaly, Longford and Westmeath ahead of a public meeting in Mullingar Park Hotel on Wednesday, October 21st.

The region is currently an end of life care “blackspot” with no Level III inpatient hospice unit and has one of the lowest levels of investment in palliative care nationally, the IHF says.

Launching a campaign to highlight the inequities and to bring the Midlands up to a par with other parts of Ireland the IHF CEO, Sharon Foley said: “The people of the Midlands deserve better. Without a Level III hospice, and the resultant specialist palliative care services that comes with it, patients are being denied the best possible care on their final journey. The 300,000 plus people who live in the Midlands should have the same chance to live well until the end as those living in other parts of Ireland. The current situation is completely unacceptable.”

“Figures show that only €7.66 per head of the population is invested by the State in specialist palliative care in the Midland counties compared with €30.68 per head in the Mid West (Limerick, Clare, North Tipperary). The fact that there is no inpatient (level III) hospice in the region means patients have no option but to be admitted to the acute hospital for care. As a result 41% of cancer patients in Laois, Offaly, Longford and Westmeath die in an acute hospital compared to only 21% in the Mid-West.”

According to Ms Foley there is a very high reliance on local hospice groups to raise money to sustain services including core palliative care services such as homecare nurses. The homecare teams do not have the dedicated support of a full multi-disciplinary team including social workers, occupational therapists and physiotherapists.

The Report of the National Advisory Committee on Palliative Care, which was adopted as government policy in 2001, clearly states: ‘Each health board area should have a comprehensive specialist palliative care service to meet the needs of patients and families in the area. This service should support the patient wherever the patient may be – at home, in hospital, in residential care, or in a specialist palliative care unit.’

Commenting on this Ms Foley said, “Despite this 14 years on there is still no Level III hospice in the Midlands, and the region has a poorly developed end-of-life care service. This is deeply disappointing.”

A number of strategic plans have been drafted since 2001 to develop services in line with the aspirations held within national policy but were hampered by health cutbacks and a public service recruitment embargo.

In 2013 the IHF funded a research project which looked at the needs within the Midlands for the development of end of life, hospice and palliative cares services. It identified critical gaps and pinpointed needs including the development of a specialist in patient unit (hospice) for palliative care and associated day services. It also called for a second palliative care consultant with supporting NCHDs, palliative care nurse specialists in acute hospitals and enhanced community/home care teams.

Ms Foley said, “A full and very detailed implementation plan was drawn up by the regional committee on palliative care in 2014 to build services in all the settings where people die – hospital, the community, and hospice. Whilst the second consultant post is in planning stages, its seems little other progress has been made, particularly in relation to the inpatient unit.”

The IHF is calling as a matter of urgency for:

  • A regional inpatient level III hospice unit, as promised in 2001, to provide support for the sickest and most complex patients AND to be a hub for outreach and education activities.
  • Immediate replacement of staff vacancies
  • Provision of full range of specialist and generalist palliative care service in each of the Midlands counties including hospice homecare nurses and supporting nursing staff, medical support, physiotherapy and occupational therapy
  • Extension of hospice homecare to allow for greater 7-day and out of hours coverage
  • A specialist outreach hospice day care service one day a week in each county
  • A regional programme of education and training in general and specialist palliative care.

The Irish Hospice Foundation is holding a public meeting in Mullingar Park Hotel on Wednesday, October 21st at 7.30pm to rally support and to put pressure on politicians to make this a priority in the lead up to the next election. 

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