Reform Of Palliative Care Services Announced, Wales

Main Category: Palliative Care / Hospice Care
Article Date: 14 Oct 2008 - 1:00 PDT

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Health Minister Edwina Hart today accepted the recommendations of a new report to improve palliative care services across Wales.

The report by the Palliative Care Implementation Group establishes a fairer funding system for hospices, based on a definition of a core palliative care service which providers will have to meet in order to secure future funding.

Services will be required to be consultant-led, with support from multidisciplinary teams including specialist palliative care nurses and other health professionals.

Improved standards of out-of-hours care will have to be met and a new patient registration card and single contact point will be explored to improve the support to patients and their families.

The health regulatory bodies in Wales will also have a greater role in regulating providers. To date, not all voluntary sector hospices have been regulated through registration.

The group recommends allocating just over half of the £1 million funding announced in July to take forward work on an all-Wales basis, including developing a single contact point for patients, a patient registration system, staff training and the development of a clinical record system.

The report also recommends transitional funding allocations for voluntary sector hospices from the £2 million funding from the Welsh Assembly Government.

This breaks down as more than £180,000 for hospices in the North West Local Health Board area; £140,000 for those in the North East; £50,000 for Powys; £275,000 for Hywel Dda; £65,000 for Abertawe Bro Morgannwg; £525,000 for Cardiff and the Vale; and £500,000 for Gwent.

The children's hospices in North and South Wales will receive £175,000 and £110,000 respectively.

All voluntary providers will have to meet service level agreements in order to receive the current year's funding and a slice of that which the Health Minister announced in July for future years.

Edwina Hart said:

"For people with progressive and life-threatening conditions good quality palliative care services are vital. I want to ensure that the level of care provided, at what is a very distressing time, is the very best possible.

"Implementing the recommendations in this report will create the infrastructure to raise the quality of palliative care from the current patchy levels that exist across Wales.

"I am enormously grateful to Baroness Finlay and the other members of the group for their hard work in producing this report.

"There is clearly a lot of work to do in ensuring that the recommendations are implemented and so I am asking the Implementation Group to continue for an initial period of a further three years."

Baroness Finlay, chair of the Implementation Group, said:

"Patients should have excellent care at the end of life wherever they are - whether it be at home, in a hospice, a nursing home or hospital bed.

"There was recognition by the vast majority of service providers that there is a need to improve the quality of services and that change would benefit patients.

"It is vital that we move to a change of work patterns in order to put the patient at the centre of their care. Most patients' care is delivered by GPs, nurses and hospital teams, but they need to be able to have the back-up and support of excellent specialist services wherever the patient is in Wales.

"The group was particularly struck by evidence from families of patients on the devastating effects of feeling unsupported out of hours and not knowing who to call.

"This is a problem to be addressed urgently and therefore the establishment of a single contact number and patient card will be explored. This would ensure patients are not sent into hospital unnecessarily, or, where they are admitted, the appropriate team are rapidly involved in their care.

"The patient card would aim to ensure that whoever meets the patient knows their needs and wishes and what their care plan is so that patients do not languish waiting to be seen."

On 24 October 2007, the Health Minister announced £2million extra funding for hospices in Wales, on top of the £10m announced over four years in 2004. The Minister also established a Wales Palliative Care Planning Group to specify what is meant by a 'core' palliative care service to determine what palliative care services hospices should provide on behalf of the NHS in future.

Subsequently, on 1 July 2008, the Health Minister announced £8m funding over the next three years (£1m in 2008/09; £2m in 2009/10 and £5m in 2010/11). Baroness Finlay was asked to chair an implementation group to provide advice on where the funding should be invested.

-- Download the Finlay Report

Welsh Assembly Government
http://www.wales.gov.uk