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President's message 2009
The mission
The new mission statement of EAPC sets the goals for our association:
"The EAPC brings together many voices to forge a vision of excellence in palliative care that meets the needs of patients and their families"
It strives to develop and promote palliative care in Europe through information, education and research using multi-professional collaboration, while engaging with stakeholders at all levels.
How are we doing with this mission? In this report I would like to describe our successes, but also the challenges we are facing.
EAPC is more and more acknowledged as a European player in the development of palliative care. We have been approached to join initiatives or programmes, or to contribute to conferences. This offers great opportunities to implement palliative care in different areas.
EAPC had been invited to contribute expert advice to the Wordarg report “Palliative Care: A model for innovative health and social policies” which had been submitted to the Council of Europe in November 2008 and has been adopted on the 29th of January 2009 by the Parliamentary Assembly of the Council of Europe. The resolution specifically recommends that members states establish a consistent and comprehensible health-policy approach to palliative care and promote international cooperation between the various organisations, institutions, research institutes and other players in the palliative care movement. These recommendations will support the development of palliative care in Europe. Together with previous recommendations from the Council of Europe and the European Parliament this will be an important tool in our advocacy work. EAPC has been involved to a large degree in the planning of an international conference on palliative care in Rome in November 2008, organized by ANTEA, an Italian palliative care service provider. In addtition to an excellent scientific programme, the conference provided an opportunity to deepen the collaboration with other associations.
More recently, EAPC had been invited to a workshop of the Health Commission related to a new initiative of the European Commission: “European Action Against Cancer”. One of the four columns in this initiative is palliative care, and EAPC will contribute to that area.
However, in other areas we still have to struggle hard to be seen. Establishing the EAPC as the competent expert partner for decision makers and stakeholders in Europe will require constant vigilance and continuous advocacy. We have to discuss how much we want to engage in advocacy work, and how much we can leave to other associations such as the International Association for Hospice and Palliative Care (IAHPC) or to the Worldwide Palliative Care Association (WPCA). The WPCA has been recently founded. EAPC is a member of WPCA as a regional representative of Europe. The collaboration offers many exciting opportunities and will provide synergistic effects, for example in the preparation of the next World Hospice and Palliative Care Day to be held on the 10th October 2009 with the theme: «Hospice and palliative care: Discovering your voice”.
However, we also have to discuss overlap of activities and agree on the distribution of work to avoid unnecessary parallel exertions. Collaboration with WPCA as with IAHPC, the European Society of Medical Oncology (ESMO) and others has been very productive and worthwhile, and we hope to continue and expand these collaborations. New partnerships are being set up with the WHO Collaborating Centre in Spain led by Xavier Gomez Batiste and with Alzheimer Europe.
Task Forces
The Task Force on Development of Palliative Care in Europe has produced several publications with data on the development of palliative care in Europe. The Atlas of Palliative Care in Europe published by this task force is one of the major assets of the EAPC and most useful for advocacy of palliative care. The task force members led by Carlos Centeno and David Clark also contributed greatly to the Martin Moreno Report to the European Parliament, making the disparities within Europe visible and point out areas in need of improvement.
Similarly, the IMPaCCT consensus paper produced by the Task force on Palliative Care for Children and Adolescents has been widely used to raise the awareness of palliative care needs in children and adolescents.
The Task Force on Better Palliative Care for Older People is preparing a booklet in close collaboration with the WHO informing about the need for palliative care in the Elderly.
The Task Force on The CEE & FSU Newsletter chaired by Katalin Hegedus had done a wonderful work with the regular publication of the newsletter (eapcnet.org/CeeFsuNlt/index.html), compiling information from and for the Central and Eastern European countries. The russian translation does a lot to disseminate the work of EAPC to Eastern Europe.
The Task Force on Nursing Education has set up the European Palliative Staging Opportunities (EPSO) platform, which will connect nurses seeking placements with services willing to offer such placements. Staging, also referred to as clinical placement is a period of clinical experience. This may be part of an academic training course, however, EPSO will focus on the clinical placement. More information can be found on the website https://eapcnet.org/projects/EPSOproject.html. We are grateful to the workgroup led by Martine de Vlieger for the preparation and organisation of this important training opportunity.
New task forces have been set up for education of psychologists, physiologists, palliative care in neurology and on family care givers in palliative care. All these task forces are working on their agenda with full energy, and I am confident that valuable results will be forthcoming in the next years.
The Research Network
The Research Network of EAPC had been set up in 1996 and has been continuously productive. A range of expert papers has been published which are cited frequently. The biannual research meetings have developed from small conferences to full blown congresses. The 5th EAPC Research Congress was organized by Stein Kaasa in Trondheim in June 2008, bringing together more than 800 participants for a three-day high ranking scientific programme. The congress was a huge success and has received much attention from palliative care experts worldwide.
The Research Network had been set up and chaired since then by Franco de Conno. In 2008, the chair changed over to Stein Kaasa. With the rotation the Research Network will undergo major restructuring. Investigators actively involved in palliative care research and leading international research projects will form the core of the revised network, which will be open for any palliative care professionals engaged in research. Closely linked to the new structure is the collaboration with the European Palliative Care Research Collaborative (EPCRC) led by Stein Kaasa. The EPCRC has presented first results at the Trondheim congress, and clinical guidelines on pain, depression and cachexia in palliative care are forthcoming.
In close collaboration with the Research Network Stein Kaasa is currently setting up a European Palliative Care Research Centre in Trondheim. Funding has been secured and the centre can be established and started. The Board of Directors of EAPC welcomes and supports the Research Centre. The establishment of this centre has great potential and it is an important development. EAPC will link closely with the centre.
Congress
The 11th congress of EAPC is now being held in Vienna in May 2009. Friedemann Nauck and Phil Larkin have done wonderful work as chairs of the Scientific and Hans-Georg Kress as chair of the Organizing Committee. The congress slogan “Committed to people” takes up the idea of the Budapest Commitments. This initiative will present first results in Vienna, with a precongress meeting and a red thread in the plenary sessions. The congress site in the middle of Europe has attracted more than 3000 participants, making this the largest congress of EAPC yet. Many participants come from Central and Eastern European countries, showing the growing development of palliative care in these countries and the continuous commitment of EAPC towards the development of palliative care in these countries.
The 12th congress of EAPC will be organized in Lisbon in May 2011. The members of the scientific committee have been appointed and the preparation of the scientific programme is being initiated. I will chair the Scientific Committee. The chair of the Organizing Committee for Lisbon is Isabel Galriça Neto, and I am very confident that together we will be able to organize an excellent congress.
The congress slogan is “Reaching out”, and indeed Lisbon is not only suited ideally to reach out from Europe to Africa or other continents or to the Middle East countries, but also the time has come to reach out from cancer care to palliative care for other patient groups.
White Papers
The Board of Directors has initiated a series of white papers, starting with a white paper on standards and norms. After drafting the paper, the definitions and statement in includes have been submitted to a consensus process with the board members of the national member associations of EAPC. The aim is to create a common language in European palliative care, providing guidance and recommendations for service providers, stakeholders and decision makers. The consensus process is nearly completed and we hope to publish the white paper in the next months.
Another white paper had been commissioned on palliative sedation. Nathan Cherny has formulated this paper as a framework, and not as a fixed set of guidelines, acknowledging the differences in culture and in clinical practice throughout Europe. The manuscript has just now been submitted for publication. More white papers will follow. The Board of Directors is currently discussing the remit for a white paper on education in palliative care. With these position papers we hope to provide guidance for the member associations and indeed for all professionals working in palliative care in Europe. We will continue to expand this line of work.
EAPC Website
Most of the information in this report and much more can be found on the EAPC website (eapcnet.org). However, the website has continued to grow for more than ten years now, and the wealth of information may be overwhelming. It is not possible to extend the current website any more and the EAPC will completely renew its website. This will take some time, but we hope to present the new EAPC website at the end of this year. This will improve the value of the EAPC website still more, having comprehensive and easily accessible information on all aspects of palliative care available to the palliative care professionals throughout Europe.
Committed to people
Compiling the report, I was once again astonished about the amount of work that had been done, on meagre funds and with a small infrastructure. To paraphrase Churchill, I think that never before so much has been done with so little. I am greatly thankful for the continuous dedication of our members, so many of whom have worked for the common cause of improving palliative care in Europe. Without your efforts and engagement we could not have achieved our successes. However, palliative care is about caring for the patient. With all strategic and political work, guideline drafting and education material, we should not forget that in the end it should be used to improve the care of the patients.
The Vienna congress has summarizes it in the slogan: “Committed to people”!
This commitment should guide us in the EAPC activities.
Thank you all for your continuous commitment!
Lukas Radbruch
President of EAPC
Aachen, 2nd May 2009
Prof. Dr. Lukas Radbruch
(President)
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