Table 1 Summary of requirements for the model in terms of drug availability, education and implementation

Established

Oral morphine is available in the country.

All essential palliative care (PC) medicines are available and affordable.

There is a critical number of health professionals who have core PC competencies for Level 1 and 2 in PC including clinical placement.

There are specialist or advanced practitioners (with PC competencies Level 3) who then will act as trainers.

There is evidence of palliative care service provision in the country.

There is a specialist multidisciplinary team (MDT) including doctors and nurses experienced and competent to support the clinical palliative care in home-based settings including end of life care.

Essential

Systems set in place for access to oral morphine at home.

Training of nurses and Community Health Workers (PHC staff) on a package for PC level 1 and 2.

Networking, supervision of interventions, routine quality support and mentoring.

Established referral pathways of patients and advice (in the 2 directions), and PC interventions are re-imbursed.

Supplementary

Possibility to use SC morphine by carer.

End of life care anticipatory medications.

Undergraduate training in PC and/or Preservice training for all health professionals in PC

Regular Continuing Medical Education (CME) for in-service healthcare professionals

Evaluation, grading and promotion of staff of services ensuring good quality

Generalist palliative care provision at all levels of the health system.

Full integration between the 3 levels of care, including shared patients’ records.

Compulsory rotation for all family physicians and oncologists in PC.