How to design and implement palliative care public health programmes: foundation measures. An operational paper by the WHO Collaborating Centre for Public Health Palliative Care Programmes at the Catalan Institute of Oncology
- Xavier Gómez-Batiste1,2,
- Jan Stjernsward1,2,
- Jose Espinosa1,2,
- Marisa Martínez-Muñoz1,2,
- Jordi Trelis3 and
- Carles Constante4
- 1The Qualy Catalan End of Life Observatory, WHO Collaborating Centre for Public Health Palliative Care Programmes, Catalan Institute of Oncology, Barcelona, Spain
- 2Chair of Palliative Care. University of Vic, Barcelona, Spain
- 3Catalan Institute of Oncology, Barcelona, Spain
- 4Catalan Department of Health, Government of Catalonia, Barcelona, Spain
- Correspondence to Dr X Gómez-Batiste, The Qualy Catalan End of Life Observatory, WHO Collaborating Centre for Palliative Care Public Health Programmes, Institut Català d'Oncologia, Hospital Duràn-Reynals, Hospitalet de Llobregat, Barcelona 08908, Spain;
This paper summarises the recommendations of the WHO Collaborating Centre for Palliative Care Public Health Programmes with respect to design and implementation of palliative care national or regional public health palliative care programmes in their initial phases. We describe the elements of a programme (leadership and aims; needs and context assessment; definition of the target patients; general measures in conventional services; specialist services in different settings; sectorised networks; education and training; availability and accessibility of opioids and essential drugs; legislation; standards; budget; valuation and improvement of quality; and evaluation of results and indicators) and the specific recommendations to implement the first steps of each component. Palliative care planning needs to be systematic, inserted in all levels of the healthcare system and adapted to the cultural and organisational status of the system. Coverage for all types of patients in need, together with equity and quality, are the main aims of programmes.
- Received 9 February 2012.
- Revision received 22 July 2012.
- Accepted 16 August 2012.
- Published Online First 4 October 2012
- Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions