The Catalonia WHO Demonstration Project of Palliative Care: Results at 25 Years (1990–2015)

Abstract

In 2015, the World Health Organization (WHO) Demonstration Project on Palliative Care in Catalonia (Spain) celebrated its 25th anniversary. The present report describes the achievements and progress made through this project. Numerous innovations have been made with regard to the palliative care (PC) model, organization, and policy. As the concept of PC has expanded to include individuals with advanced chronic conditions, new needs in diverse domains have been identified. The WHO resolution on "Strengthening of palliative care as a component of comprehensive care throughout the life course," together with other related WHO initiatives, support the development of a person-centered integrated care PC model with universal coverage. The Catalan Department of Health, together with key institutions, developed a new program in the year 2011 to promote comprehensive and integrated PC approach strategies for individuals with advanced chronic conditions. The program included epidemiologic research to describe the population with progressive and life-limiting illnesses. One key outcome was the development of a specific tool (NECPAL CCOMS-ICO(©)) to identify individuals in the community in need of PC. Other innovations to emerge from this project to improve PC provision include the development of the essential needs approach and integrated models across care settings. Several educational and research programs have been undertaken to complement the process. These results illustrate how a PC program can respond and adapt to emerging needs and demands. The success of the PC approach described here supports more widespread adoption by other key care programs, particularly chronic care programs.

Interventions at the end of life – a taxonomy for ‘overlapping consensus’

“…The development and delivery of end of life care services is closely linked to local funding and reimbursement arrangements, and is sometimes the territory of a mixed economy of publically funded, for-profit and non-profit organisations. There is also a significant interest, but no consensus, in models of service organisation and delivery, with particular enthusiasm for identifying ‘scalable’ models, which can meet changing population need and are sustainable over time 49 .…”

Compassionate communities: design and preliminary results of the experience of Vic (Barcelona, Spain) caring city

“…These were the 1 st palliative care services in Spain and were the basis for the design of the Catalan Palliative Care project. This Project was designated WHO Demonstration Project in 1990 and has been implementing palliative care services and palliative approach for chronic patients recently and showing results regularly (24). The Catalan system has implemented a wide range of specialist palliative care services, and more recently, the palliative care approach for people with advanced chronic conditions in the community (25).…”

Estrategias Regionales de Cuidados Paliativos en España: estudio descriptivo

“…Los cuidados paliativos (CP) iniciaron su implantación y desarrollo en España en los años ochenta y noventa del siglo pasado como resultado de iniciativas personales 1 , muchas veces con el apoyo de instituciones como la Asociación Española contra el Cáncer o la Orden Hospitalaria de San Juan de Dios 2 . También hubo, al inicio, apoyo institucional que permitió implementar equipos específicos, tanto en hospitales como en la atención domiciliaria, e incluso el desarrollo de un programa piloto en Cataluña, con el apoyo de la Organización Mundial de la Salud, que integraba recursos para atender pacientes crónicos avanzados, oncológicos y no oncológicos 3 .…”