On Saturday 14 October we celebrated World Hospice and Palliative Care Day, facilitated by the Worldwide Palliative Care Alliance. This is a day set aside to focus on increasing the availability of hospice and palliative care around the world. It is also a day for speaking out, creating awareness and raising funds to support people and their families who are living with chronic life-limiting conditions (http://www.thewhpca.org/about). The theme of this year’s World Hospice and Palliative Care Day was Universal Health Coverage and Palliative Care – Don’t leave those suffering behind.

At the Sixty-seventh World Health Assembly in 2014, the World Health Organization recognised the transition in palliative care services and adopted the WHA Resolution 67.19, ‘Strengthening of palliative care as a component of comprehensive care throughout the life course’. Palliative care has been a neglected health service module of the healthcare profession. With the rising rates of non-communicable diseases and the treatability of HIV and some forms of cancer, it has become more important to rethink the role of palliative care. People living with life-threatening or life-limiting conditions may live for a very long time and their needs may change over the course of their illness. As well as reducing unnecessary hospitalisation, providing palliative care at an earlier stage can improve the quality of life of patients and their families.

In light of this, Dr Aaron Motsoaledi, the Minister of Health, has appointed a National Steering Committee for Palliative Care to create “a revolution in healthcare through palliative care”. The National Policy Framework and Strategy for Palliative Care (NPFSPC) was compiled and approved by the National Health Council this year.

Palliative care, as described in the NPFSPC, is ‘the holistic multi-disciplinary care of a patient and family affected by a life limiting or life threatening illness and is applicable from the time of diagnosis for all adults and children across the life span and includes bereavement care for the family’.

The framework looks at reviewing and improving policies, increasing institutions offering holistic integrated multi-sectoral palliative care, training health care workers in palliative care, increasing institutions that provide training, increasing the availability of palliative care medications and prescriptions, improving referral pathways, increasing the number of palliative care beds available, and improving palliative care research and information.

In celebration of World Hospice and Palliative Care Day, the UP Department of Family Medicine hosted a Palliative Care Seminar, with the Faculty of Health Sciences, Steve Biko Academic Hospital and Health Care Workers in Tshwane, to plan the implementation of the NPFSPC in Tshwane.

Presentations were made by Mr Makhudu (Director PHC, Tshwane District), Dr Zele (Steve Biko Hospital), Dr Kaseru (radiotherapist), Dr Cilliers (oncologist), Dr Coetzee (SAMA), Dr Venter (Sungardens Hospice), Dr Klebanoff (gynae oncology), Dr Bhana (Dept. of Nursing Science, UP) and Dr Kruidenier (pastoral therapist). After the presentations there was a discussion to plan the way forward. From these discussions, the following action points were compiled:

• Develop a helpline for palliative care for Pretoria with one central number.
• Find some acute beds to stabilise patients.
• Get a budget for palliative care.
• Organise a mobile palliative care team.
• Have a palliative care consultant on call 24/7 who can be consulted, e.g. by old age homes.
• Plan training for WBOTs.
• Provide support for people working in palliative care and oncology.
• Find out if hospices can provide day-care.

Improving palliative care services means improving the quality of the remaining time of the patient and the family, reducing despair and striving for a peaceful and dignified death for many South Africans.

This week, 6-9 November, the Hospice Palliative Care Association is hosting its 2017 Symposium in Pretoria with theme ‘Pearls of Palliative Care – supporting hospices for 30 years’, where the significance of the NPFSPC will be highlighted.

The following institutions provide courses in palliative care (the list is not exhaustive):

Stellenbosch University:

• Palliative Care in Family Medicine: http://shortcourses.sun.ac.za/courses/c-10/2017-3522.html

University of Cape Town:

• Postgraduate Diploma in Palliative Medicine: http://www.publichealth.uct.ac.za/phfm_postgraduate-diploma-palliative-medicine
• MPhil in Palliative Medicine: http://www.publichealth.uct.ac.za/phfm_master-philosophy-palliative-medicine

Hospice Wits: https://hospicewits.co.za/training/

Hospice Palliative Care Association of South Africa: http://hpca.co.za/category/education.html