EUROPEAN insight
In this section, European palliative care organisations are invited to explain
their goals, express their hopes and voice their concerns
Development of Spanish
palliative care and the
role of SECPAL
Palliative care in Spain is arranged across different regions, with
no uniform design. The Spanish Association for Palliative Care
(SECPAL), with its regional associate members, aims to unify and
improve the provision of palliative and end-of-life care in Spain
Javier Rocafort, Past SECPAL president, Medical Director at the Centre of Care,
Laguna Hospital, Madrid; Maria Nabal, Miembro de la Junta Directiva, SECPAL
The Spanish Association for Palliative Care
(Sociedad Española de Cuidados Paliativos,
SECPAL) is a scientific society that was established
in 1992, founded by a small group of pioneers
in palliative care who had been taught in
UK hospices.
Nowadays, SECPAL has 1,818 members,
including doctors, psychologists, nurses, social
workers, physiotherapists, spiritual agents and
other professionals – not counting volunteers.
The national health service in Spain has been
decentralised into 17 autonomist departments.
Each region has its own local scientific association,
and these are SECPAL collective members. The only
autonomist regions without a palliative care
association are Rioja, Asturias and Murcia.
The Spanish Nursing Association for Palliative
Care is another SECPAL collective member.
This link with the Nursing Association was
established to promote palliative care nursing
and to facilitate participation in official institutions.
European Association for Palliative Care (EAPC)
and SECPAL members can be individual or part of
a group.
254
SECPAL objectives
SECPAL has the following objectives:
● To promote evidence-based palliative care
knowledge through education and training
● To bring together people involved in care of the
terminally ill, their families and other caregivers
● To promote research that will result in improved
quality of care
● To sensitise society and administration to the
need for adequate funding and a rational
distribution of palliative care resources
● To develop guidelines on ethical issues
associated with palliative care
● To represent the interests of its members
under the law and to the government, and to
health and educational bodies, both public
and private.
SECPAL activities
To meet its objectives, SECPAL supports and
develops events (conferences and courses) and
specific working groups.
EUROPEAN JOURNAL OF PALLIATIVE CARE, 2012; 19(5)
Copyright © Hayward Medical Communications 2012. All rights reserved. No unauthorised reproduction or distribution. For reprints or permissions, contact [email protected]
EUROPEAN insight …
The national palliative care conferences have
been held biannually since 1995, usually in the
spring. So far, nine meetings have been held, in the
cities of Barcelona (1995), Santander (1998),
Valencia (2000), Granada (2002), Las Palmas de
Gran Canaria (2003), San Sebastian (2006),
Salamanca (2008), A Coruña (2010) and Badajoz
(2012). The tenth Congress will be held in Madrid in
November 2014.
The conference is a real forum for knowledge
exchange and debate, and is the main meeting
place for palliative care professionals in Spain and
Latin America, with an average attendance of
1,000 delegates.
Throughout Spain, other conferences have been
organised. The role of SECPAL in those meetings is
variable. Highlights include the European Palliative
Care Congress held in Barcelona in 2005, which
coincided with the national congress, and the
European Research Congress on palliative care,
which will take place in Lleida in 2014. The
palliative care regional societies also hold their
conferences in different locations to attract
hundreds of participants.
During odd-numbered calendar years, SECPAL
organises palliative care national conferences with
a monographic nature. The last meeting was held
in Palma de Mallorca in 2011, using ‘spirituality’ as
its theme. The previous sites were Seville, Bilbao,
Pamplona, A Coruña, Zaragoza, Cáceres, Madrid
and Logroño, and emphasised topics such as
family, organisation, training and communication,
among others.
In recent years, SECPAL has organised a number
of courses and workshops on spirituality, quality
and research in palliative care. SECPAL also
stimulates taskforce activities to delve into specific
issues of palliative care.
As a result of these working groups, we have
produced several SECPAL consensus documents to
advise and help both members and non-members
in their professional training and work. The
following are noteworthy:
● Burnout prevention guide for palliative care
professionals
● Guide on spirituality
● Guide on palliative sedation
● Documents on informed consent and euthanasia.
Mass media and publications
Medicina Palliativa is a scientific journal and
publication of reference on palliative care in the
Spanish language. It is widely distributed in Spain
and all Latin American countries. The journal has
EUROPEAN JOURNAL OF PALLIATIVE CARE, 2012; 19(5)
been published continuously since 1994: 18
volumes, 74 numbers and more than 700 original
and review articles. Medicina Palliativa is distributed
free for SECPAL partners.
The website www.secpal.com is another massmedia resource. It is an online tool for knowledge
management and currently has over 12,000
registered professional users,
SECPAL also stimulates
who continuously update
and review the contents.
taskforce activities
In addition to regular
to delve into specific
sections, which contain
issues of palliative care
information on scientific
society itself, statutes, internal rules and history of
palliative care in Spain and links of interest, the
website also includes relevant information such as:
● Training – a calendar of major national and
international training activities
● Forum – a professional meeting place for open
discussion on various topics. To date we have
published over 3,400 messages
● Telematic library – a selection of the best
scientific articles from the best international
journals summarised and discussed, in Spanish.
In addition, it offers access to the full text of
some international publications to members.
Over 750 comments have been posted
● Palliative Medicine Review Online – the full text
of every article published in the journal in the
last 11 years is available in PDF format, free to
all members
● Palliative Care Guides – a complete professional
guide as well as several specific recently updated
guidelines
● Palliative Care Online Directory – a list of all the
specific palliative care resources in the country.
The Briefings is a SECPAL publication that offers
news related to professional teams and palliative
care. In the coming months, a new publication called
SECPAL Monograph will be made available; this will
contain specific topics of interest to the community.
SECPAL also promotes activities and joint events
with other organisations. We call your attention to
the recent creation of the Spanish Observatory of
Palliative Care in conjunction with the Spanish
Medical College.
The palliative care
situation in Spain
In Spain today, there are 419 specific palliative care
resources: 166 home support teams; 59 hospital
support teams; 37 joint support teams, who work
in both patients’ homes and hospitals; and 110
palliative care units, 34 of which are in acute
255
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EUROPEAN insight …
hospitals. There are two centres in our country that
emulate the care model for British hospices.
Together, that represents a total of 1,518 specific
palliative care beds. We also have 30 psychosocial
teams, and 17 other services.
In terms of human presence, the current number
of professionals working in palliative care is 1,937
(607 doctors, 1,058 nurses, 127 psychologists and
145 social workers). The network has been mostly
publicly funded and it is part of the global health
system for the country. Despite the efforts made by
every region to develop this area of care, the
distribution of resources has not been equitable
and its implementation has taken place under
differing priorities.
Undergraduate and postgraduate education in
palliative care is not uniform in Spain. There are few
universities that have incorporated the European
Association for Palliative Care (EAPC)
recommendations into their newly adapted
European curricula. However, the increasing
availability of palliative care university lecturers and
professors ensures that research and knowledge will
continue to move forward. Many medical disciplines
have incorporated training in palliative care into
their curriculum, including family medicine, internal
medicine, medical oncology and intensive care.
Despite progress in recent years, Spain does not
have a standardised system of accreditation for
professionals engaged in palliative care. There are a
total of six different masters degrees in palliative care
(either medical or multidisciplinary) and one masters
degree for palliative nurses. At present, SECPAL is in
discussions with the appropriate ministries in an
effort to implement an accreditation system.
The efforts of SECPAL and its professional member
have paid off in terms of important increases in
scientific production and growing contributions to
the EAPC conferences. This can be evidenced by the
growing number of participants and rising quantity
and quality of communications and posters.
Great strides have been made, but there is still
much to do as we strive together with our
European colleagues, with whom we share the
same philosophy: to provide comprehensive
quality care for those who suffer ■
Declaration of interest
The authors declare that there is no conflict of interest.
Javier Rocafort, Past SECPAL President, Medical Director
at the Centre of Care, Laguna Hospital, Madrid; Maria
Nabal, Directora de la Revista Medicina Paliativa,
Miembro de la Junta Directiva de Sociedad Española de
Cuidados Paliativos, Miembro de la Junta Directiva de
la Sociedad Europea de Cuidados Paliativos, Spain
256
In the next issue …
■ Korana Kindl,
Nathalie van
Havre and Janet
Hardy look at the
options for
managing type 2
diabetes in the
palliative care
setting.
■ Jenny Baulkwill, Andrea Dechamps, Julia
Manning,
Ninon van der Kroft and Malcolm Payne
report on an evaluation of support groups for
young people who are providing palliative
care in the home.
■ Breffni Hannon, Peter Fitzgerald
and Eoin Tiernan provide details of
the extrapyramidal side-effects of
metoclopramide in palliative care patients.
■ There are many extra considerations
when providing palliative care to a
patient with dementia. Two articles, from
Barbara Pointon and from Jo Hockley and
Min Stacpoole, look at this issue from a
carer’s perspective and a nurse’s perspective.
■ As part of the ongoing ‘A day in the life’ series,
Marina Martínez Garcia provides insight
into her work as a clinical psychologist.
■ The occasional series of articles on spirituality
in the European palliative care setting
continues with Laura Campanello,
Cinzia Martin and Filippo Laurenti
discussing Italy.
■ Julia Downing, Mackuline Atieno,
Richard A Powell, Zipporah Ali, Joan
Marston, Michelle Meiring, Jennifer
Ssengooba, Stephen Williams, Faith
Mwangi-Powell and Richard Harding
discuss the development of a management
tool for the palliative care of children in subSaharan Africa.
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