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Recommendations from the Canadian Society of Palliative Care Physicians
Steps to ensure that all Canadians have access to high-quality palliative care
1. Implement a palliative approach to care, as outlined in the national framework document The Way Forward. This approach is a high-quality, cost-effective service delivery model that will help Canadians with life-threatening illnesses live as fully as possible.
2. Make new investments to transition to the palliative approach to care, building on past investments wherever possible. Specifically:
a. Identify targeted funding to address the immediate shortfall in physician resources, in order to provide an acceptable standard of care for those who are nearing end of life.
b. Provide targeted funding to universities to ensure core competencies in palliative care are achieved by every medical school graduate.
c. Provide targeted funding to universities to at minimum double the number of residency training positions for palliative care across Canada for at least the next 5 years. Further requirements can then be assessed by the reinstated Secretariat.
d. Make a stable long-term funding commitment to Pallium Canada to enable them to continue to develop high-quality educational programs for all medical disciplines and primary palliative care providers.
e. Make a stable long-term funding commitment to Canadian Virtual Hospice to enable ongoing provision of high-quality online support for patients, families and professionals.
f. Consider strategic targeted funding for the appropriate human resources and infrastructure to meet the palliative needs of vulnerable and marginalized populations (e.g. First Nations, Inuit, Metis, rural and remote populations, and the homeless, disabled or incarcerated).
3. Set, monitor and enforce national standards for palliative care in Canada. Make accreditation of healthcare services (hospitals, long-term care homes, home care services, etc.) contingent on palliative care service provision to nationally accepted standards.
4. Promote recruitment and retention of palliative care providers, including expectations of wage equity as compared with similar work.
5. Standardize provincial drug plans and health supplies coverage to include all patients who require palliative care and the medicines and supplies needed to adequately care for them.
6. Promote technological innovation such as telemedicine and minimally invasive palliative procedures, which enable delivery of effective care to remote populations and those with the most extreme suffering.
Mechanisms for implementation
1. Establish a new national health accord that includes dedicated funding for palliative care, makes funding contingent on governments meeting national standards for palliative care and measures progress through strict reporting requirements.
2. Reinstate a Canadian Palliative Care Secretariat to provide standards to guide the provinces and territories in service development.
3. Support Private Member’s Bill C-277: providing for the development of a framework on palliative care in Canada, sponsored by MP Marilyn Gladu.