Palliative care beds may not be available in Ireland when we need them

Palliative care bed shortage

Palliative care bed shortage

According to irishhealth.com, Ireland should have 450 hospice beds available for its population, but instead has just 155, the Irish Hospice Foundation (IHF) has said.

It has just published a major new report which reveals that as many as 2,500 patients every year are denied access to inpatient hospice care as a result of a failure to develop hospice services around the country.

The report revealed a high amount of ‘regional inequity in resource allocation’. In other words, a person’s access to these vital services depends on where they live.

“This is in spite of stated national policy since 2001 to secure equity of access to specialist palliative care by providing one hospice bed for every 10,000 people,” the IHF noted.

However in reality, while there should be 450 hospice beds available, there are currently 155. Another 44 beds are ready, but are not yet operational.

In three regions of the country – the north east (Meath, Louth, Cavan and Monaghan), the midlands (Longford, Laois, Offaly and Westmeath) and the South East (Wexford, Waterford, Kilkenny and Carlow), there is no inpatient hospice unit.

The counties of Kerry, Mayo and Wicklow also have no inpatient units.

The report noted that the mid-west (Limerick, Clare and north Tipperary) and the north west (Sligo, Leitrim and Donegal) are the only two regions of the country which are close to providing one hospice bed per 10,000 of the population. However, even these regions are not fully compliant with the stated national policy.

The report pointed out that currently, 23% of people die at home each year, however this rises to 40% of all patients who are cared for by hospice home care teams. It is widely acknowledged that given the choice, most people would choose to die at home.

The report also noted that in relation to cancer deaths, the number of people who die at home, as opposed to in hospital, is lower in regions with good palliative care. For example, according to the 2010 National Cancer Registry, 21% of all cancer deaths in the mid-west took place in an acute hospital, compared to 52% in the north east and 41% in the south east.

“In some areas of the country, patients at their most vulnerable are being denied access to services simply because of where they live. Not having access to inpatient hospice beds has a critical impact on whether a patient dies in an acute hospital or not. We are calling on the government to explore what might be achievable through a broad end-of-life strategy,” commented IHF chief executive, Sharon Foley.

She said that the 2001 national policy on palliative care, and its related 2009 framework,  now needs to be updated ‘to address new challenges’.

“We believe that by managing national health resources more effectively, many more people could be facilitated to be cared for and to die outside of acute hospitals and in their preferred place of care,” she explained.

Meanwhile according to the author of the report, Eugene Murray, the demand for hospice care is expected to rise in the coming years.

“While only 26% of all deaths in Ireland occur in the home, 40% of patients cared for by home care teams die at home. Given that these will often be the patients with the most complex care needs, this is a great tribute to hospice home care teams countrywide. But where keeping the patient at home is not feasible and there is no hospice in a region, the home care team has no choice but to look for admission to an acute hospital,” Mr Murray said.

The report also highlighted the fact that hospice services can save the State money.

“Hospice services can provide real savings to the healthcare system and meet the needs of patients. By ensuring that patients with life-limiting conditions are cared for in the most appropriate setting for their needs such as hospices, the State can secure the more efficient use of acute hospital resources,” commented Dr Kathy
McLoughlin, who also worked on the report.

The report, Access to Specialist Palliative Care Services and Place of Death in Ireland – What the Data Tells Us, is based on an examination of health data from a two-year period

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