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Skip to 0 minutes and 14 seconds Services for palliative care have often developed in hospitals with a particular focus on cancer patients. In hospitals, we see a tendency towards organising specific palliative care functions– for example, consultation teams, dedicated beds for palliative patients, or a dedicated outpatient clinic or daycare.

Skip to 0 minutes and 37 seconds From 2000 onwards, we see a tendency in a setup of small, dedicated palliative care institutions, almost at home houses, palliative units, in-care and nursing homes, and high care hospices. Currently, the Netherlands has around 200 of institutions for specialised palliative care. In home care institutions– there are also developments towards dedicated palliative care functions. How large this is is not known. As Marieke says, community services are developing– either in hospices, which provide specialist inpatient beds, or hospice at home type services, where community staff provide the types of services an inpatient palliative care team might need– so community nurses and general practitioners. With regard to specific palliative care services, the EAPC Atlas 2013 detected 375 services.

Skip to 1 minute and 37 seconds 46% of the services occur within hospitals, whereas 44% represented home palliative care units. The remaining 10% corresponded to mixed support teams both working at the hospital and at home. In contrast to other countries with more hospice-based palliative care provision, in Spain, there is only one hospice. In some countries, palliative care has also developed in paediatrics and increasingly non-cancer. Two inpatient hospices have been opened for children in Hungary since 2012. They provide not only end of life care, but respite care for families, caring for children with long-term chronic progressive conditions. However, patients’ access to hospice and palliative care still can be limited in Hungary.

Skip to 2 minutes and 30 seconds The most significant reason is that despite the extensive professional educational programmes and public campaigns, patients and doctors still lack adequate information and knowledge about the possibility and benefits of hospice palliative care. There are about 300 hospices in the United Kingdom, including about 40 hospices for children and young people. Hospice and specialist palliative care services are regarded as synonymous. 80% of hospices are independent charities with very little funding derived from contracts with the NHS. There are few NHS funded hospices. Most hospices provide a range of services including inpatient beds– typically about 15 to 20 beds– home care, sometimes called “hospice at home,” daycare, bereavement support, outpatient clinics, education and research.

Skip to 3 minutes and 26 seconds There are also links to nursing homes and in some places, prisons. Most NHS hospitals have specialist palliative care teams which provide advice throughout the hospital. With an ageing population, more and more care is happening in nursing or care homes. In the Netherlands, these are often quite large care homes with dedicated palliative care services. Yes, they are quite large. We have a lot of nursing homes in the Netherlands. And some they are so large that special palliative care teams were introduced in a nursing home or they made special units for palliative care, like the hospice units– they were introduced in a nursing home.

Skip to 4 minutes and 10 seconds And all patients as well from within the nursing home as well as coming from outside can be institutionalised and taken care of in such units. Sometimes, the nursing home physician is the medical specialist in charge. Sometimes a special, dedicated palliative care doctor is in charge. And most of the time, the nurses as well as care providers from the institution– from the nursing home– work over there.

Palliative care services

Palliative care services have often developed in hospitals with a particular focus on cancer patients.

In this short film, you will hear from speakers about the extent to which this is changing within their own countries to include a broader range of services for people not only with cancer but other chronic illnesses.

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This video is from the free online course:

Palliative Care: Making it Work

Lancaster University