Care Beyond Service THE PALLIATIVE CARE STANDARD
Hospice Week takes place this week from May 5-11. Annually, this week focuses on the role the palliative care sector plays in healthcare. In South Africa, The Association of Palliative Care Centres (APCC) is the member organisation for 91 palliative care centres, many of which call themselves hospices.
In 2023, these members cared for 38,228 people. From this, 16,327 (41%) were patients and 21,901 (59%) were patient household members. The predominant diagnosis of patients was HIV/ AIDS (37%), followed by Cancer (25%), Chronic illness (23%), COVID (12%), and Tuberculosis (3%). Some patients had more than one diagnosis.
“Our members adhere to the Standards for Palliative Healthcare Services,” says Dr Ewa Skowronska, CEO of the APCC.
“The APCC is the only organisation in South Africa that has developed accredited Standards for Palliative Healthcare Services. Since the release of the national Policy Framework and Strategy for Palliative Care, there has been a mushrooming of Service Providers that are not accredited as palliative care Service Providers and that do not have the knowledge, skills, and experience to provide palliative care. The APCC is currently actively engaging with the public and private sector about the importance of integrating quality palliative care into all healthcare provision. It is a specialised skill and should be treated as one by all healthcare providers.”
To support members in gaining their accreditation, the APCC established a Mentorship Programme. The mentors (who are also members), take other members through the policies, procedures, and protocols necessary to gain a Level 1 accreditation. They then guide them through the other 4 levels.
CEO of Msunduzi Hospice Association Warren Oxford-Huggett said he has been a COHSASA accredited surveyor for many years and have worked with several sites in conducting their COHSASA assessment.
“Working with the Standards for Palliative Healthcare Services can be intimidating, particularly for members who are new to them or new to organisations that function with policy and procedures in place. The Standards help ensure that all members provide a minimum level of care that can be measured. Our objective is to help the member organisations embrace the standards not as something external and imposed, but as something that is the lifeblood of the Palliative Care they provide,” Oxford-Huggett said.
Fellow mentor Hilary Grey, CEO of Knysna-Sedgefield Hospice said it is wonderful to see other members around the country and help them implement the Standards.
“I have been a surveyor for COHSASA since 2016 and served on the WC-HPCA board with the accreditation portfolio for about 5 years, resigning in 2020. Mentoring is about taking what a site does and growing that rather than trying to squeeze them into a mould, a very satisfying experience. We always seem to find and then share best practices. I also love working with the other mentors who help interpret when there are questions or doubt about practice against the Standards. Palliative care is all about team, so this is an extension of that,” Grey said.
Mavis Tholakele Mthimkhulu (Sr. Colette), Director of Duduza Care Centre said the Association has helped them as an organisation to grow in the knowledge needed to provide palliative care and opened their eyes to new stages of opportunity and strength through the policies that enabled them to be granted a 2-star accreditation.
“Hospice White River was fortunate enough to be a part of the first round of mentorship and learning provided by the APCC,” says Terran Gericke, Manager of Hospice White River. “The goal was to increase our star rating from two to three stars which we did with the help of the dedicated APCC team.”
Tersia Burger, CEO of Stepping Stones Hospice and APCC mentor said in a hospice setting, a mentor plays a critical role in providing guidance, support, and knowledge to less experienced organisations “Mentoring enhances the quality of care provided to patients and supports the professional and personal growth of staff.”
Many South Africans will be affected by a life-threatening diagnosis at some point in their lives.
Palliative care is therefore not a luxury, but an essential healthcare service and a human right.
“Our Standards are the result of a distinguished history of service towards those requiring palliative care, and their loved ones. We are honoured to work with our members to continue ensuring that quality palliative care is accessible to all in South Africa,” added Dr Ewa Skowronska.
The patient stories received from APCC members supports the excellence of the service received. In a letter to APCC member, HospiceWits, Sasha Ryan writes: “I watched with wonder as you seamlessly integrated the art and science of nursing, masterfully navigating the complex web of medical procedures, medications, and treatments. Yet, it was your unwavering empathy, patience, and understanding that truly set you apart.”