• Corpus ID: 18524724

White Paper on standards and norms for hospice and palliative care in Europe : part 2.

@inproceedings{Radbruch2009WhitePO,
  title={White Paper on standards and norms for hospice and palliative care in Europe : part 2.},
  author={Lukas Radbruch and Sheila A. Payne},
  year={2009}
}

• L. Radbruch, S. Payne
• Published 2009
• Medicine, Political Science

The modern hospice movement was introduced by Cicely Saunders with the opening of St Christopher’s Hospice in London in 1967. However, as early as 1975, Balfour Mount found a confusion of terms when he looked for a designation for his new inpatient unit in Montreal, as in French-speaking Canada ‘hospice’ was already used in a different context, leading to the introduction of the term ‘palliative care’. The struggle for a common language has been going on since then in hospice and palliative care throughout the world and has hampered the development of international standards and norms. Recently, the European Association for Palliative Care (EAPC) commissioned a survey on the development of palliative care in European countries. The Task Force on the Development of Palliative Care in Europe, led by Carlos Centeno and David Clark, has just published the results in the EAPC Atlas of Palliative Care in Europe, providing for the first time valid data for comparison of the state of palliative care across European countries.1,2 This evaluation showed some common structures, but also a wide variety in the structure of service development and care delivery. These differences are at least partly related to different understanding of the underlying concepts and the terms of palliative medicine. The development of a common terminology has been claimed as a prerequisite for meaningful comparisons.3 Following this lead, the EAPC is now putting forward suggestions for a common European terminology following a consensus process with the national associations. Norms will be defined on the basis of this consensual terminology. Guidance on norms and standards are necessary not only for healthcare professionals working in hospice and palliative care settings, but also for decision-makers in healthcare who are responsible for adequate access to palliative care for patients. With the ongoing development of palliative care throughout Europe, decision-makers are challenged not only to decide where and when palliative care services should be developed, but also how they should be equipped and configured. Adequate structural quality is a prerequisite for high quality of care. Administrative and political decision-makers will aim for cost-effectiveness, and try to reduce costs by allocating a minimum of staff or reimbursement. Care providers will negotiate for adequate staff resources necessary for high quality of care. In this conflict, both sides will seek guidance on structural quality. In this paper, the EAPC presents norms on structural quality for the provision of palliative care with inand outpatient services in different settings. This White Paper takes into account the different concepts in the European countries and regions. This is acknowledged by the description of norms rather than the definition of standards. Whereas standards would imply an absolute limit below which quality palliative care is not possible (minimal standards), norms represent a consensus on quality goals that have to be aimed for (aspirational norms). If (or White Paper on standards and norms for hospice and palliative care in Europe: part 1