A Public Health Approach to Palliative Care and Compassionate Communities
Explore the importance of a civic and public health approach to end-of-life care, highlighting the need for prevention, harm reduction, and early intervention. Discover methods such as public education, community development, and social ecology, along with initiatives like Compassionate Communities and Compassionate Cities Charter. Join the movement towards building caring environments and promoting compassionate care for all.
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Presentation Transcript
Care 0 APublic Health Approach to Palliative Care Building Compassionate Communities & Cities Allan Kellehear, PhD, FAcSS 50th Anniversary Professor (End of Life Care) University of Bradford, UK
1 Why do we need a civic and public health approach to end of life care? Limits to service provision and professional care (the 95% rule) Stagnation/reversal of national health care budgets (the 100% and reducing rule) Epidemiology of primary care (the 40% rule) Its not the dying, grieving or caregiving it s the toll (The Hidden Story of Co-Morbidities)
2 The main ideas behind a public health approach Prevention Harm reduction Early intervention
3 The main methods Public Education Community development Health promotion Participatory action Social ecology
4 Compassionate Communities Poster campaigns World/Death caf nights Positive grieving art exhibition Annual emergencies services round table Public forum on death & loss Review of local policy and planning Annual short story competition Annual Peacetime Remembrance day
5 And more Compassionate Watch programme School and workplace plans for death & loss Compassionate book club Building/architecture prize for caring designs Academic prizes for dissertations on DDL&C Animal companion remembrance day (involve vets) Book marks, beer mats, etc
6 And the problems have been Lack of systematic or comprehensive coverage Often led by health services as services The Einstein Principle
7 Compassionate Cities Charter led ensures systematic coverage Ensures a balance between community development (bottom up) and social ecology (top down) approaches Stronger outcomes and outcome measures
8 The Compassionate City Charter Our schools, trade unions, and workplaces will have policies in EoL Care Our churches and temples will provide appropriate supports for EoL Care Our hospices and nursing homes will engage in community development Our Cultural Centres will raise awareness of EoL Care issues There will be a peacetime memorial parade/festival There will be an incentives scheme for compassionate leaders - both individuals and organisations
9 And more The Town council will showcase its achievements and ambitions in this area There will be annual local short-story or art competitions within the city to raise awareness of EoL Care We will incorporate diversity in all we do We will address EoL Care issues in the margins of our city homeless, prisons, refugees, travelers, etc We will expand our influence annually into another social sector emergency services, universities, creches, etc
10 Current global developments Wales, UK (pop. 3 million) Committed Ottawa, Canada (pop. 1 mill) Committed Plymouth, England (pop. 260,000) Committed Inverclyde, Scotland (pop. 82,000) Committed Vic (pop.42,000), & Seville, Spain (pop. 750,000) Committed Burlington, Toronto, Canada (pop. 175,000) Committed New Westminster, Vancouver, Canada, Committed Koshikode aka Calicut, India (pop. 400,000) Committed
11 In progress Cologne, Germany & Bern, Switzerland (Mayor and DPH agreed) Academic interest from Singapore and Hong Kong; Also Taipei stepping up from Com Com to Com City Austrian Red Cross to liaise with Innsbruck est. that city as a CC Mankato, Minnesota, USA currently establishing their CC network. Richmond VA also assembling a civic team. Australia has 1 conventional Com City and 12 other versions Major developments of CCs in South American cities and communities Japan has CC Research Centre
12 Professional Developments Public Health Palliative Care International (www.phpci.info) Public Health Palliative Care UK (PHPCuk) EAPC (public health) reference group Public Health England (Toolkit) Scottish Public Health Network & Scottish Partnership for Palliative Care NHS Ambitions Policy for Palliative Care 2015-2020.
13 A question of evidence (1) Evidence for Medicine Evidence for Oncology Evidence for Palliative Care Evidence for Public Health (A & D)
14 The Question of Evidence (2) O Mara-Eves A, Brunton G, McDaid D, Oliver S, Kavanagh J, Jamal F, et al. (2013) Community engagement to reduce inequalities in health: a systematic review, meta-analysis and economic analysis. Public Health Research 1(4). J. South et al (2014) A Guide to Community-centred Approaches to Health & Wellbeing: Full Report. Public Health England, London. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file /402887/A_guide_to_community- centred_approaches_for_health_and_wellbeing.pdf L. Sallnow, H. Richardson, SA Murray and A. Kellehear (2015) The impact of a new public health approach to end-of-life care: A systematic review. Palliative Medicine DOI: 10.1177/0269216315599869 People, place, purpose: Shaping services around people and communities through the Newquay Pathfinder. Age UK Cornwall and Isle of Scilly (2014)
15 And some more K. Weigletner, K. Heimerl, A Kellehear (2016) Compassionate Communities: case studies from Britain and Europe. Abingdon, Routledge. J. Abel et al (in press) Reducing emergency admissions to hospital: A retrospective cohort observational study of a complex intervention of care co-ordination and social prescribing in a large GP practice in south west England.
16 Future Challenges Quality Assurance Challenges of Evaluation Challenges of co-creation and design Digitalizing our lessons and practice wisdom Weaning ourselves off traditional service dependency Ensuring the social approaches provide the continuity of care
