Cancer Alliance Advocacy Toolkit

Palliative Care Policy – The New Policy

KNOW YOUR RIGHTS: ALL CANCER PATIENTS, IRRESPECTIVE OF WHERE YOU LIVE, HAVE A RIGHT TO PALLIATIVE CARE, STARTING AT THE TIME OF DIAGNOSIS.

Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. – World Health Organisation1

Click here for a pdf copy of the slides, or here to download the text only.

South Africa’s new National Policy Framework and Strategy on Palliative Care 2017 – 2022

South Africa has a new national policy on palliative care that aims to change the face of ongoing care for people living with life threatening illnesses including cancer, including the rich and poor, the old and the young, and those who live in cities as well as those who live in the most remote rural areas. If you don’t know what rights you’re entitled to, you won’t be in a position to demand that which is rightfully yours. We plan to remedy that with a series of information pamphlets, starting with this one, to ensure cancer patients and their families get all the help possible, at the time when they really need it.

What does this mean for you as a cancer patient?

This new policy recognises palliative care as an essential part of the continuum of healthcare delivery. This means that this vital care is no longer an option that’s available only to certain, privileged communities. The policy applies to all South Africans, regardless of income or where you live.

Models of Palliative Care that must be provided

  1. Home-based palliative care
  2. Mobile outreach services
  3. Outpatient palliative care
  4. Inpatient palliative care
  5. Hospital based palliative care teams
  6. Day care palliative services

These include:

  • Home-Based Palliative Care: When professionals and lay caregivers visit you in your home to offer physical, psychosocial and spiritual care. A qualified and experienced palliative care or hospice nurse must conduct regular assessments, and make referrals to appropriate services if necessary.
  • Mobile Outreach Services: When a mobile team visits health facilities in remote areas to see patients who are unable to travel long distances to see doctors and nurses. In cases where patients are too sick to visit even the mobile service, the team must visit them at home.
  • Outpatient Palliative Care: Patients who are well enough to visit clinics will receive palliative care there, from healthcare workers or a specialist palliative care team. These clinics include those at primary healthcare level, up to specialist clinics at tertiary hospitals.
  • Inpatient Palliative Care: A specialist palliative care unit to manage your symptoms, including pain, which cannot be managed at home. They will also offer care for the dying, who cannot stay at home. The focus is on patient comfort and reducing suffering at any stage of the illness.
  • Hospital-based Palliative Care Teams: This sees the provision of additional palliative care in terms of a specialist, multi-disciplinary team approach. They will support the medical teams treating patients in hospitals.
  • Day Care Palliative Services: These centres can be independent or attached to a clinic or hospital, but they will offer the patient and the family programmes to help them cope with the illness. These can include occupational therapy and even skills training, and counselling should also be available. This type of service is often supported by volunteers.

What about Medication, Counselling, Access to Other Therapies and Transport?

The new policy is clear that you are entitled to palliative care at varying stages of your illness, from first cancer diagnosis to end-of-life support.

These include:

  • Medication to control distressing symptoms.
  • Nursing care at the clinic or at home.
  • Counselling for you and your family.
  • Support from social workers to make UIF applications, to access social grants and/or other documentation.
  • Assistance to access transport to hospital.
  • Access to allied health services, including physiotherapy, occupational therapy, speech therapy, a dietitian and/or nutritional support.
  • Assistive devices and care at home. 2

Why Is Access to Palliative Care So Important?

Studies have shown that:

  • Getting palliative care soon after diagnosis increases patients’ coping abilities and their quality of life.3
  • Getting hospital-based palliative care resulted in patients spending less time in intensive care units, and they were less likely to be readmitted to the hospital after they went home.
  • Patients had better quality of life and experienced fewer and less severe symptoms. These included less pain, less shortness of breath and less depression following palliative care involvement and care planning.
  • Palliative care may also increase survival. Patients in a 2010 study who were given palliative care alongside best supportive cancer treatment lived nearly three months longer than those who got no palliative care. 4, 5

What Are Our Ongoing Concerns?

The national Policy Framework and Strategy for Palliative Care has the potential to improve the care of people living with cancer. It is however essential that the government drives the initiative, ensuring the policy remains an active document that guides provincial strategy to implement its content, so ensuring that those who need palliative care actually receive this vital care.

We also call on the government to ensure that the policy is adequately funded and that healthcare workers are trained to provide palliative care to all – adults and children.

 

References

  1. World Health Organisation. WHO Definition of Palliative Care. Retrieved on March 3, 2017, from http://bit.ly/PalCareDefn
  2. National Policy Framework and Strategy on Palliative Care 2017 – 2022 http://bit.ly/PalCarePol
  3. Hospice and Palliative Care Association of South Africa. Palliative Care. Retrieved on March 3, 2018, from http://bit.ly/PalCareWhatis
  4. Asco Conquer Cancer Foundation. The Importance of Palliative Care for Patients and Caregivers. Retrieved on March 3, 2018, from http://bit.ly/PalGuide
  5. Temel, Jennifer S., et al. “Early palliative care for patients with metastatic non–small-cell lung cancer.” New England Journal of Medicine 363.8 (2010): 733-742. doi: 10.1056/NEJMoa1000678. http://bit.ly/2Ktg6i3

 

Social media

  1. South Africa has a new palliative care policy. Do you know what that means for you? See http://bit.ly/PalCarePol #PalliativeCare #LetsTalkAboutCancer #RightToHealth http://bit.ly/PalCareToolkit
  2. Do you know someone who has cancer? Are they getting the support they need to cope with the impact of their illness? #PalliativeCare#LetsTalkAboutCancer #RightToHealth http://bit.ly/PalCareToolkit
  3. #PalliativeCare improves the quality of life of patients and their families throughout their journey with cancer. It is not just end-of-life care. #LetsTalkAboutCancer #RightToHealth http://bit.ly/PalCareToolkit
  4. Did you know that a #PalliativeCare policy means that cancer patients can get advice about UIF and social grants? #LetsTalkAboutCancer #RightToHealth http://bit.ly/PalCareToolkit
  5. #PalliativeCare is an essential part of the healthcare that you are entitled to. The policy applies to all South Africans, regardless of income or where you live #LetsTalkAboutCancer #RightToHealth http://bit.ly/PalCareToolkit
  6. #PalliativeCare can be provided to you at home, at a clinic, at a hospital or through a mobile service. #LetsTalkAboutCancer #RightToHealth http://bit.ly/PalCareToolkit
  7. Did you know that our #PalliativeCare policy means that cancer patients can get help at home? #LetsTalkAboutCancer #RightToHealth http://bit.ly/PalCareToolkit
  8. You are entitled to #PalliativeCare from the moment that your cancer is diagnosed. This will help you with medication, nursing, counselling, support and access to allied health services #LetsTalkAboutCancer #RightToHealth http://bit.ly/PalCareToolkit
  9. #PalliativeCare helps you to cope with your illness. It improves your quality of life and can make your symptoms less severe #LetsTalkAboutCancer #RightToHealth http://bit.ly/PalCareToolkit
  10. Do you know that the #PalliativeCare policy means that you and your family are entitled to counselling after a cancer diagnosis? #LetsTalkAboutCancer #RightToHealth http://bit.ly/PalCareToolkit
  11. The #PalliativeCare Policy is just a document unless it is adequately funded and healthcare workers are trained to provide the service for all #LetsTalkAboutCancer #RightToHealth http://bit.ly/PalCareToolkit
  12. Are you a healthcare worker? Have you been trained to provide #PalliativeCare to your patients? #LetsTalkAboutCancer #RightToHealth http://bit.ly/PalCareToolkit
  13. We call on the government to ensure that the national #PalliativeCare policy becomes an active provincial strategy #LetsTalkAboutCancer #RightToHealth http://bit.ly/PalCareToolkit

Return to Palliative Care Policy Toolkit.