Planning and implementing palliative care services: a guide for programme managers.

This is a practical manual on how to plan and implement palliative care services, integrated into existing health-care services, at national or subnational level. It has been designed primarily for health programme managers at national, provincial, or district level, whether they are responsible for noncommunicable diseases, infectious disease programmes, health services, or other technical areas where palliative care is important.

It aims to describe a range of options and starting points for building and strengthening palliative care services. A step-wise approach is outlined in each section as much as possible, with an emphasis on approaches that are feasible for low- and middle-income settings. This manual should contribute to providing equitable access to good palliative care in the context of Universal Health Coverage; it should help countries to strengthen palliative care programmes especially at primary health care level and across disease groups. The approach is based on people-centredness with an aim to address the patients’ needs and expectations. To do so, health services need to involve health-care workers as well as the patients and their communities in a proactive way, taking into account the social and cultural specificities.

This manual does not cover clinical guidelines or protocols for patient care – existing WHO guidance for pain and symptom management and a range of further tools and resources that users may find helpful are listed at the end. In the future this manual should be complemented with a series of publications addressing more specific aspects of palliative care and additional measurement tools to monitor the quality of palliative care at country level.

Access to palliative care has been identified as a fundamental right. With this manual WHO reaffirms its commitment to work with Member States in order to ensure that this becomes a reality for everyone: adults, older people and children.