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Table 2 Recommendations for Integrated Palliative Care at macro, meso and micro levels, presented in rank order

From: Recommendations on priorities for integrated palliative care: transparent expert consultation with international leaders for the InSuP-C project

Ranking

Recommendation

Macro

Meso

Micro

Item No.

1

Palliative care should be integrated into mandatory education for undergraduate medical, health and social care professionals.

✓

  

12

2

Outcome measures to assess quality of integrated palliative care services should be developed.

 

✓

 

1

3

The digital transfer of information should be integrated within and across different palliative care services and general services including community and hospital teams, and patients and families.

 

✓

 

3

4

National palliative care regulations and policies should be extended to apply to all patients with palliative care needs, not just those with cancer.

✓

  

5

5

Clarification of the language and terms used to describe integrated palliative care and associated services is needed.

✓

  

10

6

There is a need for strong leadership to advocate for integrated palliative care.

✓

  

16

7

Raise awareness of integrated palliative care for senior managers and policy makers.

 

✓

 

20

8

Disease/condition specific national policies should integrate palliative care.

✓

  

15

9

Continuing professional development for all health and social care professionals should include coverage of integrated palliative care.

✓

  

13

10

For integration to work, new and creative ways of securing resources and specific funding should be established which can support the palliative care infrastructure.

✓

  

4

11

There needs to be national level strategic lobbying to develop and fund better integrated palliative care.

✓

  

9

12

Develop alliances within and between sectors to build better integration.

 

✓

 

11

13

Social care should be part of integrated palliative care.

✓

  

14

14

Establish needs based referral systems to guide timely referrals to integrated palliative care.

  

✓

18

15

Outcomes of integrated palliative care should be audited and benchmarked.

 

✓

 

22

16

Building of informal relationships are a foundation for formal structures which are pivotal for the integration of palliative care.

  

✓

6

17

Clinical protocols should be introduced to ensure integration of services for patients and families regardless of the setting where they are treated.

  

✓

7

18

Develop systems that provide adequate out-of-hours palliative care so that health care practitioners can maintain their work/life balance.

  

✓

8

19

Access to readily available and affordable essential medicines are necessary for integrated palliative care.

  

✓

21

20

An information hub (online or face-to-face) with a care co-ordination team should be established to contribute to the integration of palliative care services across the area.

 

✓

 

2

21

There is a need to invest in the development of future palliative care leadership skills.

✓

  

17

22

Establish a single point of contact for integrated palliative care at local level.

  

✓

19

23

Raise public awareness about palliative care and its integration with healthcare.

  

✓

23

  

10

6

7

 
  1. The recommendations were attributed to three levels:
  2. • macro – national/international level
  3. • meso – organisational/institutional level
  4. • micro – interactions between patients, families and health and social care professionals