The development of hospital-based palliative care services in public hospitals in the Western Cape, South Africa

Abstract

Author contributions. RK, LG and PR conceived the article. LG wrote the introduction and development sections. RK, PR and TC composed the section on GSH.LG, HG and JS were responsible for the partnership section.RK, LG, PR and CC wrote on identifying patients. LG and RK compiled the community resources section. All co-authors reviewed the article, added comments and made editorial changes, which were included by LG.Funding. None. Conflicts of interest.None.

Approaches to integrating palliative care into African health systems: a qualitative systematic review

“…This was facilitated using referrals and members from the PC team attending ward rounds or offering consultations on symptom management. ‘Outpatient clinics’: many interventions used this mechanism to integrate PC into a facility, ( Molyneux et al , 2013 ; DesRosiers et al , 2014 ; Cornetta et al , 2015 ; Lowther et al , 2015 ; Zipporah, 2016 ; Gwyther et al , 2018 ). Usually individuals were seen together with their caregiver; however group outpatient clinics were also described ( DesRosiers et al , 2014 ).…”

“…These were often home visits ( Herce et al , 2014 ), according to set criteria, such as those whose mobility is heavily effected ( Hongoro and Dinat, 2011 ) and children whose caregivers could not carry them in ( Amery et al , 2009 ), and also found in the form of mobile clinics ( Herce et al , 2014 ), visits to other facilities, such as children homes ( Amery et al , 2009 ) and other health centres ( Tapsfield and Bates, 2011 ). ‘Telephonic advisory service’: telephonic consultations were used to manage patients’ symptoms at home ( Hongoro and Dinat, 2011 ; Cornetta et al , 2015 ) and to provide follow-up and bereavement calls ( Gwyther et al , 2018 ). ‘Treatment plans’: specialist PC teams often developed care plans that would be used while the patient is in the facility and following discharge.…”

“…For example, providing PC is thought to result in benefits that spill into and strengthen other health system functions and improve the quality of care ( Knaul et al , 2017 ). These benefits include supporting the development of responsive, patient-centred health systems, where patients’ needs guide treatment ( Green and Horne, 2012 ; Gwyther et al , 2018 ), and enabling and motivating staff to be able to provide the care needed by those with life-threatening illness ( Grant et al , 2017 ). Integration of PC is also thought to reduce the number of end-of-life hospital admissions, which has potential cost-saving benefits and can relieve congestion in health facilities ( Hongoro and Dinat, 2011 ).…”

The utility of a shortened palliative care screening tool to predict death within 12 months – a prospective observational study in two South African hospitals with a high HIV burden

“…1 A simplified version (in particular designed to fit on a single printed page) of the GSF-PIG has been used in two public sector hospitals in the Western Cape Province for several years already to aid clinicians in the identification and referral of patients for local palliative care programs. 18 This study aims to test the shortened GSF-PIG tool in patients admitted to general medical wards in two public sector hospital in South Africa, in the context of the double burden of disease. 19…”

The utility of a shortened palliative care screening tool to predict death within 12 months – a prospective observational study in two South African hospitals with a high HIV burden

“…The South African National Policy on Palliative care of 2017 suggested development of a SA Palliative Care assessment tool modelled on the GSF-PIG and SPICT, but also discusses that this tool still needs to be validated for general use [1]. A simplified version (in particular designed to fit on a single printed page) of the GSF-PIG has been used in two public sector hospitals in the Western Cape Province for several years already to aid clinicians in the identification and referral of patients for local palliative care programs [18].…”