A priority for 2024 is to continue implementing the recommendations from the HSE 2020 report 'Clinical Governance and Operational arrangements for supporting a model of care for children with life limiting conditions towards the end of life in the community in Ireland'. The new HSE Service Plan 2024 will underpin further improvements in children’s palliative care services. A multiagency approach is adopted to provide palliative care to children in their homes. This approach involves: collaboration between primary care, regional paediatricians, and adult community palliative care services - coordinated by the Clinical Nurse Coordinator (CNC) - and supported by paediatric palliative care team located in CHI Crumlin/Temple St. One of the cornerstones of children’s palliative care is to facilitate a fully integrated approach to care.
There have been significant increases in funding to enhance the provision of children’s palliative care services across Ireland in recent years. Across 2021 and 2022, funding was allocated for the recruitment of 12.5 additional whole-time equivalents to enhance the provision of children’s palliative care services across acute and community settings. These posts support the provision of specialist palliative care to children as close to home as possible.
In 2023, a Government allocation of €3.7million was provided for new measures in palliative care. These measures enhance the provision of adult and children’s specialist palliative care services across the country and include funding to support bereavement services for parents and families who have experienced the death of a child. The Palliative Care Budget increased to a total national service plan allocation in 2022 of €121.9 million from a national service plan allocation of €119m in 2021. In 2023, the budget was €130.1m.
Additional resourcing was provided in 2021/2022/2023 to support the Children's Palliative Care Programme. This included:
• €2.3 million in recurring funding to enhance and develop LauraLynn’s Children’s Hospice and outreach services. This funding has been used to increase LauraLynn’s Hospice in the Home Service across Leinster; and supported the opening of new LauraLynn Hubs in Munster and Connaught.
• 8.5 additional Clinical Nurse Coordinators (CNCs) were provided to take the total number of CNCs nationally to 18.5. This will ensure there are two CNCs in each Community Health Organisation.
• 2 Consultants in Paediatric Palliative Medicine, 1 Specialist Register, 3 Clinical Nurse Specialists and a Clerical Officer Grade IV for the Specialist team in Childrens Health Ireland Crumlin. These posts are partially recruited.
• The creation of 4 Regional Paediatricians with a Special Interest in Palliative Medicine for Waterford, Cork, Limerick and Galway to enhance regional leadership and support professionals delivering palliative care to children in their home. It’s expected these posts will be recruited in 2023.
The Department and HSE will continue to progress developments for children’s palliative care services in Ireland, working towards the highest possible quality of end-of-life care and support for children with life limiting illnesses across the country.