Training health professionals in palliative care

Lessons from South Africa

Palliative care should be an integral part of every health care professional's role; education in palliative care forms the foundation of quality care for patients and their families.

A key aspect of palliative care training involves raising the awareness of health care professionals, service providers and users. Palliative care should not just be seen as the compassionate care of dying patients but as an active discipline including assessing and treating pain and other problems. Health care workers need specific training to be able to offer quality palliative care to their patients.
In South Africa palliative care training was traditionally carried out by hospices and offered to volunteer carers. Since 1989 hospice training centres have trained nurses in palliative care.

Palliative care training falls under the Health and Welfare Sector Education and Training Authority (HWSETA). Hospice Centres for Palliative Learning have applied for HWSETA accreditation to include curricula and training courses developed by the Hospice Palliative Care Association (HPCA), an interdisciplinary introduction to palliative care, and palliative care for children. A training programme for psychosocial and spiritual palliative care will be piloted from May 2006.

The Cape Peninsula Technical (CPUT) and Pretoria Technical Universities both offer degree courses in palliative nursing; CPUT also offers a Masters degree. The University of Cape Town offers postgraduate courses for doctors working with patients with terminal illnesses.

Collaboration with medical schools has led to the integration of palliative care into the undergraduate curricula of all medical schools. The South African Nursing Council is working towards including palliative nursing in the initial training of all nurses.

The challenges ahead

• Perception: palliative care must be seen by health care professionals as far more than compassionate companionship and acknowledged for its professionalism.
• Attitude: health care professionals are trained to cure. If this isn't possible doctors and nurses must be encouraged with training not to opt out of patient care.
• Human resources: qualified health care professionals are in short supply in the face of South Africa's worst health care crisis. A clear cut career path in palliative care is needed.
• Funding is needed to pay health care professionals working in palliative care and to develop palliative care training sites: there are currently no full-time professional palliative care trainers in medical or nursing schools.

Current training initiatives are effective and have led to better patient and family care. By educating community leaders the growing pool of palliative care professionals may soon reach the critical mass needed to initiate changes in attitude towards palliative care.

The Department of Health in South Africa has established a working group to ensure the integration of palliative care into the health care sector. An education and training team is working to identify a strategy to provide training for health care professionals in the work place.

Palliative care is growing as a professional discipline and the initiatives on many fronts in education and advocacy provide hope for health care professionals, patients and families.

Liz Gwyther
School of Public Health, University of Cape Town, Observatory 7925, South Africa
lgwyther@cormack.uct.ac.za

See also

Hospice Palliative Care Association of South Africa
www.hospicepalliativecaresa.co.za

Views expressed on these pages are not necessarily those of DFID, IDS, id21 or other contributing institutions. Copyright remains with the original authors but (unless stated otherwise) any article may be copied or quoted without restriction, provided both source (id21, insights) and authors are properly acknowledged and informed. Copyright © 2006 id21. All rights reserved.