Official title of the project

Development of Palliative Care Services in Serbia

Sectors

Project information

Subtitle
Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccabl
Region / City
Cities
Serbia
Total budget of programme / project

€ 4.1M

EU contribution: €3.5 M

Co-financing: €0.6 M Ministry of Health

Implementation period
2011. Mar - 2014. Mar
Expected results

Current results are:

1.       A model of palliative care including a psychologist, a psychiatrist and an occupational therapist as well as representatives of different religious communities and volunteers is prepared for all levels of palliative care. The model is tested in pilot institutions at at all levels of palliative care;

2.       Home palliative care teams comprising a doctor, nurses, a physiotherapist, and a social worker are trained in a basic training course on the principles and practice of palliative care. All members of staff in these teams have completed a second level course in palliative care;

3.       In addition to home palliative care, teams based in 24 general hospitals have completed level 1 and level 2 training courses;

4.       Palliative care curricula developed for medical schools and study programmes of relevant higher education establishments in line with the Serbian health care system organisation in a way that palliative medicine is a compulsory part of the undergraduate curriculum;

5.       Continuous medical education (CME) training programmes in palliative care standardised and accredited; academic education programmes in palliative care standardised and accredited; palliative care curricula implemented in Belgrade School of Medicine.

 

Expected results:

1.       Palliative Care Services model for provision of palliative care services at all levels of care (primary, secondary and tertiary) developed and tested

2.       Palliative care curricula for medical and nursing schools developed, agreed and implemented in a way that palliative medicine/palliative care is a compulsory part of the undergraduate curriculum

3.       Continuous medical education programmes developed, accredited and provided to more than 1,000 practicing doctors, nurses, social workers and others in the Serbian health care system

4.       Awareness on palliative care raised amongst policy makers, health professionals and general population

Beneficiary

Ministry of Health

Target Groups
  • Patients in need of palliative care and their families
  • Health care professionals and relevant members of the interdisciplinary teams providing palliative care (social workers, psychologists and volunteers)
  • Students of

Summary of the project

Palliative care in the context of advanced disease and end-of-life care in the final months and weeks of life represents the last phase of health and social care for citizens before their death. These are matters of huge importance which create enormous challenges for health professionals, patients, families, and policy-makers.

When death is seen as a medical failure rather than a natural inevitability, then supporting end-of-life patients and their loved ones with their physical and mental needs becomes problematic. For most of the 20th century, this situation was the reality throughout the world. However, in the late 1960s this began to change. In 1967 Cicely Saunders founded St Christopher’s Hospice in South London, the first modern hospice in England, combining clinical care, psychological support, education and research. This full “body and mind” approach was singular in its recognition of real patient needs, and provided a platform for innovative practice and service delivery that is now developing in many different forms around the world.

These principles have struck a chord in other healthcare settings and countries worldwide, and beginning in the 1970’s, first services began to appear elsewhere in Western Europe: in Norway (1976) Sweden (1977), Italy (1980), Germany (1983), Spain (1984), Belgium (1985) and the Netherlands (1991). In Eastern Europe and Central Asia, there were few palliative care developments in the years of Soviet domination, with notable exceptions such as a volunteer hospice service in Krakow, Poland as early as 1976. The fall of the Soviet Union was followed by palliative care developments in Hungary (1991); Bulgaria, Romania, the Czech Republic and Slovenia (1992); Lithuania (1993); Estonia and Latvia (1997); and Slovakia (1999).

These developments were guided and supported first by national activists in grassroots movements. Within the larger context of a more united Europe, howe

Programme/Project objectives

  1. To support the development of comprehensive and modern systems of palliative care in Serbia, accessible to all patients who require such care, be they patients with cancer or non-cancer disease, adults or children. An over-arching principle is that access to relief of pain and to palliative care services is a basic human right.
  2. To provide basic training and education in the principles and practice of palliative care to mulitidisciplinary teams providing palliative care (doctors, nurses, sociologists, psychologist, volunteers, etc) and students of medical and nursing schools throughout Serbia.

More details on project

1. Technical assistance

Name: Development of Palliative Care Services in Serbia

Budget: 2.5M

The project is implemented by Oxford Policy Management (UK) in a consortium with Gesellschaft fur Versicherungswissenschaft und gestaltung e.V - GVG (GER), BELhospice (SER), Hospices for Hope (UK) and Casa Sperantei (ROM).

Contact details:

Prof Julia Downing, Team Leader, E-mail: julia.downing@palliativecareserbia.com

Dr Natasa Milicevic, Project National Coordinator, E-mail: natasa.milicevic@palliativecareserbia.com

Brief summary of the project:

The project “Development of Palliative Care services in the Republic of Serbia” is providing technical assistance for the establishment of a comprehensive and modern system of palliative care in Serbia. It is assisting the Ministry of Health in its effort to make these services accessible to all patients who require them, including adults and children with advanced cancer or non-cancer disease, and will support accessibility for potentially underserved population groups. An over-arching principle guiding the Project’s activity is the belief that pain relief and access to palliative care are basic human rights.

 

2. Supply/Equipment

Name Development of Palliative Care Services – supply of vehicles

Budget: €0.468M

The project is implemented by Auto kuca “Kole” (SER).

Brief summary of the project:

A contract was signed (13/06/2011) for the supply of vehicles to cover the needs of palliative care and home care units at primary health care centres. After the contract duration had expired only 6 vehicles were delivered and it was subsequently terminated, bank guarantees revoked and penalties applied. A new tender was launched for the purchase of 54 vehicles (value 6,990 EUR per vehicle – FIAT Panda) and another 13 contracted as additional quantities totalling in 67 vehicles under one contract (total value: 468,330 EUR). The first 54 are now being delivered and the remaining 3 are expected to arrive by end of July 2013. The vehicles are donated to the Ministry of Health for primary health care institutions throughout

 

3. Supply/Equipment

Name Development of Palliative Care Serices – supply of equipment

Budget: €0.343M

The supplies were delivered by Globe B.V (NL).

Brief summary of the project:

This contract was for the supply, delivery, installation, commissioning, training and after-sales service of palliative care hospital equipment to earmarked health institutions (198 final sites) of the Ministry of Health of Serbia. The contract was closed in 2012 and all equipment delivered in July 2011, within the given timeframe (165 days). The equipment procured includes hospitals beds, Mayo tables, anti- bedsore mattresses, cloths and air-pads, commode chairs, wheelchairs, syringe drivers for the careful dosing of opiates, walkers, hydraulic lifts and suction pumps. This was delivered to all future palliative care units throughout the country and is currently used in geriatric or intensive care units where PCUs are not created.