Support and advice for 8 pilot outpatient and home-based palliative care

Eight pilot outpatient and home-based palliative care (PC) centres will receive support and advice through the PalPlan project, coordinated by the Romanian Ministry of Health, together with 4 other partners: National Authority for Quality Management in Health, Ministry of Labour and Social Protection, National Health Insurance House, HOSPICE Casa Speranței Foundation (Increasing institutional capacity for coordinated national development of palliative and home care / SIPOCA 733 / MySMIS 129439).

Eight counties or hospitals, each of them representing a region in Romania, were selected, based on clearly defined criteria (estimated number of patients with PC need over 4000-5000 patients, presence of trained staff, degree of coverage of palliative care needs by existing services, etc.) to become pilot centres for outpatient and home-based palliative care:

  1. Târgu Mureș County Clinical Hospital, MS/ Centre
  2. Ploiesti Emergency County Hospital, PH/ South
  3. Hospital “Prof Dr Irinel Popescu” Băilești, DJ/ South-West
  4. Vatra Dornei Municipal Hospital, SV/ North-East
  5. “Pius Brînzeu” Emergency County Clinical Hospital Timisoara, TM/ West
  6. ”Buna Vestire” Obstetrics and Gynaecology Hospital Galati, GL/ Sed-Est
  7. Turda Municipal Hospital, CJ/ North-West
  8. Curtea de Argeș Municipal Hospital, GA/ South

These units will receive support and advice, i.e. consultancy in staff recruitment, access to specialist training, professional development through monthly clinical mentoring, as well as adequate equipment of the centres, according to the Equipment Guide. The funding of the pilot centres activity during and after the completion of the PalPlan project will be done through a contract with National Health Insurance House, according to the 2021-2022 / 2022-2023 Framework Contract.

Why the PalPlan project supports the development of specialised palliative care services in the AMBULATORY and at HOME?

– Two out of three patients prefer to be cared in outpatient or at home care (EAPC, October 2021). However, in Romania the number of providers of such services has decreased or remained far below what is needed, without adequate financial allocation (2017 – 17 HPC providers, 2019 – 9 HPC providers, only NGOs and LLCs).

– In Romania approximately 176,156 people need palliative care annually. The degree of coverage of the need for palliative care in 2019 was 18.71%. Only 5.20% of palliative care beneficiaries were cared at home and 4.84% received outpatient consultations (Analysis of palliative care providers in Romania).

– Palliative care in specialist outpatient clinics and at home can lead to decongestion of acute hospitals, especially welcome in a pandemic context. In addition, it reduces high costs in the ICU and acute wards.

– Home care expands the capacity of hospital care in the community and ensures continuity of care.

– Outpatient clinics provide continuity of care for patients throughout the trajectory of the progressive chronic diseases and for monitoring patients in the relatively stable stages of illness, when they do not need hospitalisation or palliative care at home.

Why the PalPlan project supports the development of pilot centres for each of Romania’s 8 regions?

– To ensure equal access to health services/palliative care for all Romanians, regardless of the stage of economic development of the region where they live.

– To collect data uniformly from all regions in order to develop evidence-based health policies and realistic budget projections that will form the basis of the National Palliative Care Programme that will be operational from 2024.

– National objective: “Increase the coverage of the population with basic services such as emergency care, increase by 50% the access to health care services (long term care) of the elderly population, increase the coverage of palliative services to 60% of the need and of community psychiatry services to 70% of the need” (National Strategy for Sustainable Development of Romania “Horizons 2013-2020-2030”).

– National objective “Development of palliative care – a component of integrated treatment in continuing care throughout the life course”(WHO Resolution 67.19 / 23 May 2014).