The HSE has announced plans to develop a costed model for the provision of out-of-hours (OOH) home-based specialist palliative care services.
The development comes amid an increase in demand for community-based palliative care services nationally, particularly OOH.
The HSE recently went to tender for researchers to conduct a 12-month review to inform the development of the model.
The review will include engagement with stakeholders and providers of specialist palliative care and primary
care services.
Access to specialist palliative care OOH is “highly variable”, according to tender documents.
“People with palliative care needs who are unable to access adequate palliative care in a timely fashion are frequently required to attend an emergency department. GPs and other primary care clinicians are integral to the effective provision of OOH palliative care.”
There is evidence that access to specialist palliative care services “reduces symptom distress and improves the chances of dying at home”.
A review study “emphasised that the strongest evidence for improved patient outcomes was linked to SPC [specialist palliative care] services offering face-to-face care and 24/7 telephone advisory services”.
However, in Ireland, some but not all SPC services provide telephone advice services during OOH, the HSE stated.
“In addition, some services provide OOH home visits or ‘face-to-face care’ and some provide admission to inpatient hospice care OOH,” according to the tender.
The document outlined that the National Clinical Programme for Palliative Care wants to ensure there is “uniform access to urgent, emergency, and out-of-hours palliative care across all regions”.
This includes the need for enhanced collaboration between service providers to ensure the provision of urgent OOH care to reduce “avoidable and/or inappropriate presentations to emergency departments and the acute
hospital setting”.
“Service planning for the provision of OOH services for patients with palliative care needs will be included in population-based resource allocation models for palliative care,” according to the tender.
“Determination of appropriate rapid or urgent response models of palliative care provision in order that they might be designed, tested, and scaled to national implementation in the future” is also planned.
The HSE will establish a project steering group to oversee the methodology required to develop an options appraisal and model of service.
On completion of an options appraisal process, the steering group will make its recommendations to the National Clinical Programme for Palliative Care.
Meanwhile, the Department of Health has announced plans to review the National Children’s Palliative Care Policy (2009) in line with a commitment made in the Programme for Government 2025.
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