End-of-life care


THE NATIONAL Economic and Social Council’s endorsement of the Irish Hospice Foundation’s work on standards and quality in end-of-life care will be a fillip to all who succour the dying and the bereaved. In its report, Quality and Standards in Human Services in Ireland: End-of-Life Care in Hospitals, NESC highlights the success of the IHF’s Hospice Friendly Hospitals programme and those who have been implementing it throughout the country.

Twenty-seven acute and 30 community hospitals are striving, with some success, to implement the Hospice Friendly Hosptials progamme Quality Standards for End-of-Life Care in Hospitals.

However, in a significant recommendation, NESC says these voluntary standards need official underpinning by the Department of Health and the HSE and that the Health Information and Quality Authority could integrate the HFH voluntary code into other national health and social care standards. It even suggests that funding could be linked to each hospital’s implementation of the standards. There is a warning too that, as the main phases of the HFH programme are over, some of the innovation and engagement in its work could be lost.

This would be an injustice to the nearly 30,000 people who die each year in Ireland and their relatives. The message that no one should die alone and in pain, that the wishes of dying people should be respected, and that if possible patients should be facilitated if they want to die at home, was stressed at the Forum on End of Life.

The NESC’s clear call for greater official involvement to sustain the gains emanating from the HFH programme is not without danger. HFH has been succeeding because of its professionalism and substantial funding from The Atlantic Philanthropies, but also due to its initiation by the IHF, a voluntary body, with all the flexibility, vigour and originality that allows.

A major IHF task will be to reinforce the evidence that good end-of-life care can save money, as well as being beneficial for patients and their families. The NESC, addressing this point, says “overall it seems that implementation of several of the HFH standards would not only improve quality of care and service user satisfaction, but could also generate significant cost savings”.

When hospital employees communicate effectively with patients and families, respect treatment wishes and work in a multidisciplinary way, not only does quality of end-of-life care improve, but costs are reduced. There is a convincing message here for Government.

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