Hospice And Palliative Care Act (Hospiz- Und Palliativ-Gesetz) in Germany

Key Contextual Factors

• The German statutory health insurance covers completely the necessary medical care for terminally ill patients.

Key Components/Steps

• November 2015: The Hospice Palliative Care Act was passed by the German Parliament and came into force in December 2015.
• The main objectives of the act were:

• Improving access to hospice and palliative care services for all settings in Germany.
• Strengthening cooperation between professional and voluntary services, medical, nursing, hospice and psychosocial support in networks.
• Provision of customized advice and support to patients/families about the availability of services.

• Implementation at the federal level and Laender/regional level by way of secondary legislation (guidelines, regulations, contractual agreement, legal acts).

Main Impacts / Added Value

The “2015 Hospice Palliative Care Act” has significantly:

• Further developed hospice and palliative care in Germany ensuring equitable access to multi-disciplinary and cross-sectoral services for all settings (at home, nursing/care homes, hospitals and hospices).
• Provided legal clarification that palliative care is an integral part of medical care provided by the German Statutory Health Insurance.
• Introduced additional ambulatory medical services for the delivery of especially qualified and coordinated medical care.
• Improved funding of hospices for children and adults (in-patient care) as well as ambulatory hospice care.
• Strengthened palliative care and the awareness for the need of hospice care in in-patient nursing homes as well as hospitals.

Lessons Learned

• In a federal system formal approaches (e.g. legislation) are effective to implement programmatic public health policy. Involvement of all stakeholders and levels of decision making is paramount.

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