White Paper on Standards and Norms for Hospice and Palliative Care in Europe [Новость добавлена - 23.03.2010]

March 2010

Press release:

The need for Hospice and palliative care to relieve suffering of patients with progressive and incurable disease is well acknowledged, and in many ‘European countries governements are looking for guidance on how to establish and implement palliative care in their health care system.

Prof. Lukas Radbruch, President of the European Association for Palliative Care, states “We need a common language and a joint understanding of the basic concepts of palliative care in Europe, to make sure that every patient who needs it is getting high quality palliative care.”

The European Association for Palliative care has led a consensus on norms and standards to provide this guidance. The White Paper on Standards and Norms for Hospice and Palliative Care is published now in the European Journal of Palliative Care, providing definitions, an overview of the philosophy of palliative care and recommendations for the number of services, staffing and service provision in different settings.

Prof. Sheila Payne, Chair of Hospice Studies at the University of Lancaster, said “The White Paper provides all necessary information for those who are responsible to implement palliative care in the European countries. Governements are requested to translate these informations into action, in order to provide access to palliative care throughout Europe.”

Background information:

White Paper on Standards and Norms for Hospice and Palliative Care in Europe
Recommendations from the European Association for Palliative Care

With the ongoing development of palliative care throughout Europe, decision makers are challenged not only to decide where and when palliative care services should be developed, but also how they should be equipped and configured. Adequate structural quality is a prerequisite for high quality of care. Administrative and political decision makers will aim for cost-effectiveness, and try to reduce costs by allocating a minimum of staff or reimbursement. Care providers will negotiate for adequate staff resources necessary for high quality of care. In this conflict both sides will seek guidance on structural quality.

The European Association for Palliative Care (EAPC) has put forward a White Paper on Standards and Norms for Hospice and Palliative Care in Europe. The White Paper includes recommendations for a common European terminology following a consensus process with the national palliative care and hospice associations. Representatives of 35 different national hospice and palliative care associations from 22 European countries have participated in the consensus procedure. Norms are defined on the basis of this consensual terminology. Guidance on norms and standards are necessary not only for health care professionals working in hospice and palliative care settings, but also for decision makers in health care who are responsible for adequate access to palliative care for patients.

In this paper, the EAPC presents norms on structural quality for the provision of palliative care with in- and outpatient services in different settings. This White Paper takes into account the different concepts and cultural background in the European countries and regions. This is acknowledged by the description of norms rather than the definition of standards. Whereas standards would imply an absolute limit below which quality palliative care is not possible (minimal standards), norms represent a consensus on quality goals that have to be aimed for (aspirational norms). If (or when) norms are achieved high quality can be safely expected.

The White Paper covers key elements of palliative care: definition and terminology of palliative care and hospice care, common values and philosophy of palliative care, levels of care, patient groups, needs assessment and requirements for different types of services and settings.

As an example the demand for inpatient palliative care units is described as 80-100 beds per million inhabitants, Palliative care units require a highly qualified, multidisciplinary team. The core team consists of doctors and nurses. The extended team comprises relevant associated professionals like psychologists, physiotherapists, social workers or chaplains. The demand for home palliative care teams is described as 10 services per million inhabitants. The core team of a home palliative care team is accessible for 24 hours per day and consists of 4 – 5 full-time professionals, comprising physicians and nurses with specialist training, a social worker and administrative staff.

The European Association for Palliative Care is a non-governemental organisation with members in 40 countries, including collective members from 45 National Associations in 27 European countries, representing more than 55000 health care workers and volunteers working or interested in palliative care. Its mission statement aims for universal access to excellent palliative care throughout Europe:

The EAPC brings together many voices to forge a vision of excellence in palliative care that meets the needs of patients and their families. It strives to develop and promote palliative care in Europe through information, education and research using multi-professional collaboration, while engaging with stakeholders at all levels.

More information on the European Associaton of Palliative Care:

Click here to download the White Paper on Standards and Norms