Impact of the COVID-19 pandemic on palliative care services in the Cape Metro District of South Africa

Background: The COVID-19 pandemic exacerbated the need for palliative care (PC) and exposed gaps in PC provision in South Africa’s already-strained healthcare system. PC is a neglected yet core component of South Africa’s public healthcare sector. Aim and objectives: The study aimed to describe the impact of the COVID-19 pandemic on PC services in one healthcare district of South Africa, the Cape Metro Health District. Specifically, the study objectives were to describe the PC response to the COVID-19 pandemic, and healthcare managers’ perceptions of PC provision during the pandemic. Methods: Data for the study were derived from a desktop analysis of documents relating to PC service delivery over the pandemic, and from focus group discussions held with 19 senior healthcare managers. Results: The COVID-19 pandemic expedited integration of PC services into the health system and raised awareness of the importance of PC service delivery. It facilitated the allocation of increased resources (financial, infrastructural, and human resources) and enabled the rapid development of training material, in situ support for clinicians and the development of patient referral mechanisms. It was a stimulus for many people to learn about PC and influenced the perspectives of those working in healthcare, including managers, many of whom experienced the loss of family members or friends, foregrounding the importance of PC. Conclusion: Planning for future pandemics needs to include recognition of and ongoing care for palliative care patients and factoring in an increased demand.