Levels of Palliative Care

Palliative care is often described in terms of three ascending levels of specialisation. 

Levels of palliative care

Level one – palliative care approach:

Palliative care principles should be practiced by all health care professionals. The palliative care approach should be a core skill of every clinician at hospital and community level. Many patients with progressive and advanced disease will have their care needs met comprehensively and satisfactorily without referral to SPC units or personnel. The palliative care approach aims to promote both physical and psychosocial well-being. It is a vital part of all clinical practice, whatever the illness or its stage and is informed by knowledge and practice of palliative care principles. 

Level two – general palliative care:

At this level, a proportion of patients and families will benefit from the expertise of health care professionals who, although not engaged full time in palliative care, have had some additional training and experience in palliative care, perhaps to diploma level. This intermediate level expertise may be available in hospital or community settings.

Level three – specialist palliative care:

Specialist palliative care (SPC) services are those services whose core activity is limited to the provision of palliative care. These services are involved in the care of patients with more complex and demanding care needs, and consequently, require a greater degree of training, staff and other resources. SPC services are those services with palliative care as their core speciality and which are provided by an inter-disciplinary team, under the direction of a consultant physician in palliative medicine. SPC services are available in primary care settings, acute general hospital settings and specialist inpatient units (ie hospices). 

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