independent

Thursday 17 April 2014

Palliative care quality little more than a ‘postcode lottery’

TERMINALLY-ILL patients are denied adequate palliative care depending on where they live, a new report has found.

Nearly half the counties in Ireland have no in-patient hospice units, with the North East, South East and the Midlands among those at a geographical disadvantage due to a lack of beds.



Professor Mary McCarron, dean of health sciences at Trinity College Dublin (TCD), which published the report, said more needs to be done to ensure everyone has access to quality care.



"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," she said.



"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."



Other disadvantaged regions include counties Mayo, Wicklow and Kerry, and in some areas where there are facilities, a lack of resources has forced them closed.



"New in-patient bed facilities in Cork and north Dublin, for example, haven't been able to open because of a lack of resources," Prof McCarron said.



"Something needs to be done to address this, as everyone should be given the opportunity of quality care and a good death."



The specific regions were identified in a recent 2013 study by the Irish Hospice Foundation, she added.



The TCD report, published by Prof McCarron and colleagues from the School of Nursing and Midwifery, examined an investment programme launched nine years ago to improve quality of care for those close to death.



The Atlantic Philanthropies End of Life programme was launched in 2004 with 25 million euro (£21 million) of funding.



According to Prof McCarron's report, the programme led to increased access to care following investment in services in hospices, hospitals and at home.



This included the Marymount Hospice in Co Cork - a new in-patient hospice facility - which almost doubled its number of hospice beds from 24 to 44.



It also led to the establishment of the first of its kind All-Ireland Institute for Hospice and Palliative Care - a group of eight health agencies and four universities working to strengthen research, training and standards.



Elsewhere in the report, experts found few non-cancer patients who were dying had access to hospice treatment.



Prof McCarron said measures were needed to ensure those close to death - cancer patients or not - could also benefit from the care.



However, a hospice at home service run by the Milford Care Centre based in Limerick reported that non-cancer referrals increased from 13% in 2008 to 30% in 2010.



"Ensuring that everybody has a good death. How do we do that in the current economic climate with reduced finances? We have to measure value for money," Prof McCarron added.



"We need to ensure that we invest in further training for communities, for families, for people who are not working in the specialist centres to have the training to ensure that everybody gets the care they need and has the opportunity to a good death."



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