IRELAND IS A WORLD leader in hospice care, but there are regional inequalities in the system, a new report says.

The report was published by the Dean of Health Sciences at Trinity College Dublin (TCD) Professor Mary McCarron and colleagues at the School of Nursing and Midwifery.

End of Life programme

The report examined the Atlantic Philanthropies-funded End of Life programme, which aims at improving the care and quality of life for patients dying from an incurable illness, and ensuring they and their families receive excellent end-of-life care and services.

The programme was carried out by several organisations including the Milford Care Centre, Limerick; the Irish Hospice Foundation; Marymount Hospice; the All-Ireland Institute for Hospice and Palliative Care and the Irish Association for Palliative Care.

Commenting on the significance of the findings, Professor McCarron said:

At a time when there is so much focus on the challenges to be faced in healthcare this report highlights tremendous achievement in the expansion of availability and quality in palliative care. Nevertheless it also highlights some of the challenges still to be faced including some remaining regional inequities. Even in an environment of more restrained resources a roadway is provided on where next steps should occur.“

Findings

The ‘End of Life’ programme received €25 million in funding from Atlantic Philanthropies and commenced in 2004. Its aims included improving services at hospices, supporting education and research activities and funding accreditation and advocacy efforts.

The report says that this programme “had considerable success in expanding and improving the provision of end-of-life care”, including:

• Increased access to care in all settings following investment in hospice, hospital and at home.
• Increased awareness of hospice and palliative care nationally
• Increased access to care for non-cancer patients
• Increased education programmes spanning basic to specialist levels of palliative care
• Establishment of the first all-Ireland Institute for Hospice and Palliateve Care

However, some challenges do exist, including the fact that the programme has increased capacity in regions that previously had few hospital resources – but it has not fully addressed geographical inequities.

A continuing issue is poor communication between specialist palliative care provision and end-of-life care provided by generalists. There has also been insufficient statutory support to implement comprehensive specialist palliative care provision in low-resources regions.

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