Training curriculum enabling governance and operational arrangements

Abstract

In Ireland, the model of paediatric palliative care provision is guided by national policy frameworks, including the 2020 Health Service Executive (HSE) Clinical Governance and Operational Arrangements for a Community-Based Model of Care for Children with Life-Limiting Conditions in Ireland. This letter highlights how this and other policies have driven the integration of paediatric palliative care training within the 2023 Adult Palliative Medicine Higher Specialist Training (HST) curriculum in Ireland. This HSE framework formalises existing practice by ensuring that every child requiring end-of-life care outside the hospital is supported by a designated multidisciplinary “core team”. This team comprises a local paediatrician, community specialist palliative care team (CSPCT), General Practitioner, and Clinical Nurse Coordinator (CNC). Approximately 67 paediatric patients supported by a CNC die each year, with around 50% receiving end-of-life care at home in the community. This underscores the infrequency of paediatric end-of-life care, with resultant limited experience of many paediatric and primary care providers. Adult CSPCTs are recognised as essential to bridge this service gap...