Article Text

Primary-level palliative care national capacity: Pallium Canada
  1. Jose Pereira1,2,
  2. Srini Chary2,3,
  3. Jonathan Faulkner2,
  4. Bonnie Tompkins2 and
  5. Jeffrey B Moat2
  1. 1Family Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
  2. 2Pallium Canada, Ottawa, Ontario, Canada
  3. 3Division of Palliative Medicine, Foothills Hospital, Calgary, Alberta Health Services, Edmonton, Alberta, Canada
  1. Correspondence to Dr Jose Pereira, Family Medicine, McMaster University Faculty of Health Sciences, Hamilton, ON L8P 1H6, Canada; jpereira{at}


The need to improve access to palliative care across many settings of care for patients with cancer and non-cancer illnesses is recognised. This requires primary-level palliative care capacity, but many healthcare professionals lack core competencies in this area. Pallium Canada, a non-profit organisation, has been building primary-level palliative care at a national level since 2000, largely through its Learning Essential Approaches to Palliative Care (LEAP) education programme and its compassionate communities efforts. From 2015 to 2019, 1603 LEAP course sessions were delivered across Canada, reaching 28 123 learners from different professions, including nurses, physicians, social workers and pharmacists. This paper describes the factors that have accelerated and impeded spread and scale-up of these programmes. The need for partnerships with local, provincial and federal governments and organisations is highlighted. A social enterprise model, that involves diversifying sources of revenue to augment government funding, enhances long-term sustainability. Barriers have included Canada’s geopolitical realities, including large geographical area and thirteen different healthcare systems. Some of the lessons learned and strategies that have evolved are potentially transferrable to other jurisdictions.

  • education and training

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Supplementary materials


  • Twitter @jeffmoat

  • Presented at J Pereira. (Plenary). Building Primary-Level Palliative Care Capacity Through Education across Canada: The Pallium Canada Experience. 15th World Congress of the European Palliative Care Association. Madrid, Spain, 18 May 2017.

  • Contributors JP is the cofounder of Pallium Canada and has provided leadership as scientific lead and officer since its inception. This has included input on programme design, development, evaluation and deployment. JBM and JF have provided programme coleadership for the last three years and have contributed significantly to its operations, development and recent scale-up and spread, including its IT infrastructure and the development of the social enterprise model. SC has served as coclinical lead of the programme since 2007, is a member of the programme’s board of directors since 2010 and has provided input on various aspects of the programme’s deployment. BT has led the implementation and spread of Pallium’s compassionate communities initiatives. All authors contributed to this work, prepared this manuscript and approved the final draft.

  • Funding Pallium Canada is registered in Canada as a non-profit, charitable organisation. It has been funded mainly by contributions from Health Canada (the Canadian Federal Ministry of Health), through course registration fees and more recently through unrestricted grants from the Li Ka Shing Foundation, the Canadian Medical Association and Boehringer Ingelheim (the latter to support COVID-19 webinars that are referred to in this paper). From 2013 to 2016, this was enhanced by funding from a private benefactor, the estate of Mr Patrick Gillin of Ottawa, Canada. Smaller levels of funding have been received from some provincial government ministries to support provincial-level work, including the Ontario Renal Network, Cancer Care Ontario and the Government of New Brunswick. Supplementary revenues have come from Pallium Canada’s Palliative Pocketbook and from various organisations and service providers who have adopted the LEAP Programme to train their workforce.

  • Competing interests JLP (scientific officer), JF (vice president of operations) and JBM (CEO, Pallium) are all paid staff members of Pallium Canada. The other authors have, over the years, received stipends by Pallium Canada for their curriculum development and delivery contributions.

  • Provenance and peer review Not commissioned; externally peer reviewed.