The role of specialist palliative care: establishing what needs for happen to ensure that people die well in Ireland. Dr Karen Ryan, Consultant in Palliative Medicine, St Francis Hospice and Mater Misericordiae University Hospital. Clinical Lead, Palliative Care Programme, HSE.

PALLIATIVE CARE: PROVIDING QUALITY CARE THAT PATIENTS WANT close communication about their care vigorous treatment of pain and other symptoms relief from worry, anxiety and depression treatmentreliefinformation well-coordinated care and transitions support for family caregivers a sense of safety in the healthcare system coordinationsupportsafety

THE NUMBER OF PEOPLE WITH CHRONIC CONDITIONS IS INCREASING RAPIDLY Source: Shin-Yi and Green, RAND, October 2000.

Diagnosis of serious illness PALLIATIVE CARE IS APPROPRIATE AT ANY POINT IN A SERIOUS ILLNESS Life-prolonging treatment End of life care Palliative Care Bereavement

Palliative Care is the responsibility of the entire health system. It is provided by specialist and generalist practitioners working in partnership.

THERE HAVE BEEN SIGNIFICANT ADVANCES IN PALLIATIVE CARE PROVISION IN IRELAND Report of the National Advisory Committee on Palliative Care, 2001 The Palliative Care Needs Assessment for Children, 2005 Palliative Care for All- Integrating Palliative Care into Disease Management Frameworks, 2008 National Quality Standards for Residential Care Settings, 2008 Palliative Care - A Five Year/Medium Term Development Framework, 2009 Palliative Care For Children With Life-Limiting Conditions In Ireland- A National Policy, 2010 Establishment of the Palliative Care Clinical Programme, 2010

HOWEVER, GAPS IN SERVICE PROVISION REMAIN needs assessment service provision communication and coordination of care inequitable deficits inadequate community supports & out of hours provision carer supportcarer education variablesuboptimaldeficits

OPPORTUNITIES TO PROVIDE THE QUALITY CARE THAT PATIENTS WANT STEWARDSHIP whole systems approach FINANCING HUMAN RESOURCES PHYSICAL RESOURCES ORGANISATION AND MANAGEMENT OF SERVICE DELIVERY

Conclusions: Palliative Care: Is not dependent on prognosis and can be delivered at the same time as disease modifying treatment. Has the ultimate goal of improving quality of life for patients and families facing serious illness. Represents a paradigm shift for managing life-limiting conditions, providing interdisciplinary coordination and team-driven continuity of care while efficiently utilizing healthcare resources and delivery systems. Achievements to date provide an indication of what can be achieved by a visionary and universally accepted palliative care strategy, leadership on a national and local level and community engagement. Addressing outstanding deficiencies in palliative care provision is a key solution to challenges facing Irish healthcare system.