21 May 2024 | Country Update
Latvia introduces mobile palliative care teamsPalliative care is provided at primary, secondary and tertiary levels.
Primary level services include general (non-specialized) palliative care at home provided by the GP, ambulatory nurse or social worker. Secondary-level services at ambulatory level are specialist consultations, services provided by the so-called Pain cabinets and day care services. Pain cabinets and day care services are additional secondary care services. Tertiary level palliative services are provided in the specialized palliative care units in the Latvian Oncology Center and Children’s Clinical University Hospital.
The first palliative care unit in the Latvian Oncology Center was established in 1997, with 25 beds and an interdisciplinary team (doctors, nurses, social worker, psychotherapist, chaplain), which provides a model of bio-psycho-social and mental care. Specialists from other hospital departments are also involved, if necessary. On average, 700–800 patients are hospitalized annually.
Specialized palliative care for children was established in 1998 when the first palliative care unit opened at the Children’s Clinical University Hospital. The service provides consultations for patients within various departments of the hospital, consultations with patients’ relatives throughout Latvia, and home care for patients who live in Rīga City and surrounding areas; 24-hour telephone consultancy on palliative care for a child and his/her relatives is available.
Palliative care has been set as one of the priorities highlighted by the Oncological Disease Control Programme (2009) recommending care to be provided by a multidisciplinary team consisting of specialized oncologists, nurses, nurse assistants, social workers, chaplains and voluntary care providers. However, the programme has not been fully implemented due to insufficient resources.
Several medical institutions offer temporary social care beds as a kind of municipal social service. In line with hospital reforms, several small hospitals were transformed into social and palliative care centres (Bauska, Iecava, Irlava, Līvāni and Mazsalaca).
Palliative care beds are situated in the seven regional multiprofile hospitals (Daugavpils, Jēkabpils, two in Liepāja, Rēzekne, Valmiera and Ventspils). Financing for palliative inpatient treatment is the same as for other inpatients. As the demand for palliative care exceeds the provision covered by public funds, palliative care is also provided as an OOP service.
In late 2023, state-paid palliative care services were introduced, allowing care at the patient’s residence. Mobile palliative care teams, consisting of doctors of several specialties and medical assistants and/or nurses, were established to provide both face-to-face visits and remote consultations. The palliative care mobile team provides 24/7 support, including needs assessment, and development of care and therapy plans. Services include consultations, transportation to and from medical facilities, provision and training for technical aids, psychosocial rehabilitation, and social care. These services are available on weekdays, weekends, and holidays, ensuring comprehensive and continuous support for patients and their families.
The service is available to individuals who have received a decision from the council of doctors of a level IV or V inpatient treatment facility indicating a need for palliative care at home and a predicted survival of up to six months. Outpatients can be referred to the council by a family doctor or a specialist doctor.