UTILITY of NECPAL
The NECPAL’s main objective is to early identify persons with palliative care needs and life-limiting prognosis (in the so-called 1rst transition) in health and social services to actively improve the quality of their care, by gradually installing a palliative approach which responds to their needs. This comprehensive and person-centred approach, focused on improving the quality of life of patients, combines a multidimensional assessment with Advance Care Planning and explores patients’ values and preferences. It also includes the revision of treatments and the development of and integrated care model in all settings by actively involving patients (and families) and healthcare professionals. This approach also promotes the right to receive a comprehensive and integrated care.
The gradual insertion of this “palliative approach” must be compatible, inclusive, and synchronic with treatments focused in the control of illnesses, and curative approach of concurrent processes, avoiding dichotomist approaches.
The dimensions of the NECPAL tool allow a checklist multidimensional approach.
Timely identification aims an actively improving the quality of care through inserting a palliative approach, which has shown benefits for patients. Although recent data allow the identification of the risk of mortality at mid-term basis, this utility needs to be used cautiously, especially in the care of individual patients. In services with high prevalence of patients with complex and advanced chronic conditions, a screening should be performed in order to determine the prevalence of target patients, and promote the adoption of systematic policies of improving the quality of palliative care (training, changes of the organization).