Palliative Care
Palliative care aims to relieve total pain
At every step, right from diagnosis
Palliative care enables people living with a serious illness to receive medical care through a connected multidisciplinary team approach.
Palliative care is care that is responsive to the needs of patients. It focusses not just on the illness (chronic or life-threatening) but on how the illness is impacting the physical, social and emotional well-being of patients as well as that of the family.
Sadly, only 4% of patients in India with serious illnesses get access to pain relief 1. Others end up living in physical pain and emotional distress, with a severely compromised quality of life. Access to palliative care can address this effectively.
Learn about our work
OUR MISSION
Integrating Palliative Care Early Into Treatment
Growing evidence suggests that palliative care is most effective when considered early in the course of an illness. Yet, many health care providers, patients and caregivers view palliative care as end-of-life care and seek it very late, or not at all.
“Early integration of palliative care into oncology practice goes a long way in improving the quality of life as well as outcomes for patients.”
Dr Rajendra Badwe
Director, Tata Memorial Centre, Mumbai
Integrating palliative care early into treatment, leads to:
Greater adherence to curative treatment
Better symptom and pain management
Less distress amongst patients and caregivers
Fewer emergency hospital admissions
Better preparedness and planning as the illness progresses
Cipla Foundation has been building access for palliative care services.
We are creating awareness and acceptance for early palliative care amongst health care practitioners, policy makers, public health professionals, patients and their families.
Our work is anchored in the Cipla Palliative Care & Training Centre, Pune and we support palliative care organisations across the country.
Cipla Foundation has been building access for palliative care services.
We are creating awareness and acceptance for early palliative care amongst health care practitioners, policy makers, public health professionals, patients and their families.
Our work is anchored in the Cipla Palliative Care & Training Centre, Pune and we support palliative care organisations across the country.
CIPLA PALLIATIVE CARE & TRAINING CENTRE, PUNE (CPC)
“Cipla is not just about making medicines, it’s about making a difference. I wanted a Centre where cancer patients and their families would be cared for in the most difficult times of their life.”
Dr Y K Hamied
Chairman, Cipla Ltd
Founder, CPC, Pune
CPC was started in 1997 when palliative care was in its infancy in India. Since then, the Centre has been providing free-of-cost care to patients and their families through:
In-patient Admissions
We provide care through a unique ‘Family Care’ approach where a family member stays at the Centre and is equally cared for by the team. Caregivers are also skilled in the care of patients including wound management, diet, exercise and more.
Out-patient Services
Home Care Services
A dedicated team provides free-of-cost care to patients in the comfort of their homes in Pune city. This allows care to be continued for patients who leave the Centre and for those living in remote locations unable to visit CPC.
Teleconsultations
We provide counselling support through audio and video conferencing. These services have been especially useful to provide timely care to patients and their families isolated in their homes in Covid.
18,500 +
Patients & their caregivers have received free-of-cost care till date
To learn more about how care has been continuing all through Covid
Compassion Lies At The Heart Of Our Care
See how our team has been filling lives with hope and happiness, even in the most difficult of times.
Our doctors practice and prescribe heartfelt laughter and love
Our physiotherapists support patients, but know that caregivers need care too
Our support staff are lovingly called Mamas and Maushis because of the affection with which they care
With creative recipes like healthy ladoos, our nutritionist makes meals into feasts
When our home care team visits patients, they take time to bond, like family members do
Our nurses have a talent for winning hearts, in the wards and beyond
Our Medical Social Workers don’t just counsel, they take every opportunity to celebrate life
PALLIATIVE CARE AT CPC
Striving to integrate palliative care early into treatment
Developing Integrated Care Plans With Treating Doctors
CPC’s multidisciplinary team (comprising of doctors, nurses, medical social workers, pain specialist, physiotherapist and nutritionist) has regular team meetings to prepare a holistic care plan for patients.
The team coordinates with the treating doctor to achieve best outcomes for patients and their loved ones.
Setting Up Palliative Care OPDs In Hospitals
At the 4 OPDs that CPC runs in hospitals in Pune, our team works along with the treating oncologists to ensure that palliative care is integrated into treatment plans for patients and their families.
Our team does a comprehensive psychosocial, clinical and nursing assessment to identify the areas of support that would benefit the patient.
Training Health Care Providers In Palliative Care
The CPC team runs several training courses for health care professionals and specialists.
The trainings aim to build awareness amongst the health care community as well as assist and upskill them to apply a palliative care lens in their treatment protocols.
Over 2,700 health care professionals were trained in 2020-21.
To know more about our training programmes
Case Study | Filling Pushpa’s life with hope and dignity
To read how the Cipla palliative care team’s involvement, right from diagnosis, helped Pushpa and her family manage her cancer. See how the Centre’s team has been been bringing holistic care and comfort to Pushpa and her loved ones from 2013, till date.
PALLIATIVE CARE PARTNERSHIPS
Taking palliative care services across the country
With 13 partners in 7 states
The collective learning of over two decades at the Cipla Palliative Care & Training Centre (CPC), Pune has informed and fuelled the work of Cipla Foundation to partner with organisations to expand and deepen access to palliative care across the country.
From April 2020 – June 2021, we have served
6,400+
Patients
9,900+
Caregivers
“At Cipla Foundation we are privileged to have the opportunity to work alongside and learn from governmental, implementing and donor agencies. We will continue to strengthen our partnerships in the years ahead to achieve our vision of embedding palliative care into the health care system – where the focus is not just on treating the illness but also on responding to how the illness is impacting the daily life of patients and their families.”
Dr Prakash Fernandes
Head, Palliative Care Partnerships, Cipla Foundation
With A Special Focus On
Early Integration Of Palliative Care Services, We Are :
Place your cursor over the location on the map to view our partners at each location.
DEVELOPING NEW PALLIATIVE CARE MODELS
Together with institutions that previously did not have any palliative care services, we have been developing unique models to deliver palliative care to patients, as early as possible. Specifically, we have been deepening our work by setting up – Dedicated Pediatric Palliative Care Units and Palliative Care Services for Serious Illnesses Beyond Cancer.
Dedicated Pediatric Palliative Care Units
An estimated 1.6 million children in India need specialised pediatric palliative care2
Growing evidence suggests that families who receive early palliative care have an improved quality of life, including better symptom management and parental adjustment.
In 2019, we set up dedicated pediatric palliative care units – the first-of-its kind such facilities at a charitable and municipal hospital in Maharashtra:
- BJ Wadia Hospital for Children, Mumbai
- CSM Hospital, Kalwa, Thane (together with Tata Memorial Hospital)
“Our collaboration with Cipla Foundation focusses on integrating pediatric palliative care within the public health care system. Covid has made this even more urgent. We had to broaden our approach in the pandemic to fulfill the varied needs of the families – from supporting them in their homes with rations to conducting online counselling and support group meetings for those unable to visit the hospital etc. This is what palliative care professionals are trained to provide.”
Dr. Jayita Deodhar
Professor, Department of Palliative Medicine
Tata Memorial Hospital, Mumbai
NEW LAUNCHES IN 2021
Backed by the success of earlier units, we launched a pediatric palliative care OPD at the BYL Nair Hospital, Mumbai in partnership with Tata Memorial Hospital – the first such facility in a municipal hospital in the city.
The team of doctors, nurses, counsellors and social workers at these facilities are providing services to children who have a wide spectrum of serious illnesses.
“We are working not only with children but also with their parents and siblings as a unit. While engaging in play, we are able to win the children’s trust and get their perspective of their illness – we address their fears which they are hesitant to share otherwise. It has deepened our commitment to ensure that we integrate palliative care early into treatment at Nair Hospital.”
Palliative Care Services For Serious Illnesses Beyond Cancer
We have been striving to mainstream early palliative care for patients with any life-limiting or life-threatening illness, beyond cancer.
In 2018 – we partnered with SNEHA, Mumbai to set up Romila Palliative Care, Mumbai. This service provided OPD as well as home care services to patients with any serious illness.
In 2021 – the Romila team has expanded its teams and training programmes to create more awareness about the need for palliative care services.
NEW LAUNCHES IN 2021
SUKOON NILAYA – Mumbai’s first inclusive supportive care centre focusing on non-cancer conditions – in partnership with the King George V Memorial Trust.
The unit offers free-of-cost, in-patient and out-patient services and will shortly begin providing home care services too.
The service is also building the capacity and confidence of caregivers to encourage a smooth transition of the patient to home-based care.
“Sukoon Nilaya has given us the chance to create awareness about palliative care for all serious illnesses. In the last few months we have been interacting with health care providers all over Mumbai to dialogue on how palliative care can make a difference to their patients and caregivers.”
Adding Palliative Care Services To Serve Patients Better
We are adding palliative care delivery models (home care and out-patient) to make existing palliative care services at organisations more seamless. This is enabling patients to receive continued care at different sites.
Dr B Borooah Cancer Institute (BBCI), Guwahati
BBCI is a cancer care hospital and research centre in Guwahati, that has an in-patient and palliative care OPD facility. In 2019, we supported BBCI to add home care services so patients, especially those living in remote areas of Guwahati, can receive pain relief and supportive care.
The Pain Relief and Palliative Care Society (PRPCS), Hyderabad
PRPCS is a charitable cancer care organisation in Hyderabad, that has an in-patient service and palliative OPD for pediatric patients. We supported PRPCS in July 2021 to develop their home care programme so that children and their families could receive a holistic package of care throughout their treatment.
Indian Institute of Head and Neck Oncology, Indore Cancer Foundation
Indore Cancer Foundation is a not-for-profit cancer care organisation, that has an in-patient palliative care unit at their head and neck cancer hospital. We partnered with them in 2019 to set up an integrated palliative care OPD so that patients diagnosed with cancer could receive a coordinated care plan for their symptoms as well counselling services.
Strengthening Existing Palliative Care Services Across India
In 2021, we continued to strengthen partners working in the following areas:
Home Care Services For Cancer Patients In Delhi And Mumbai
CanSupport
Has the mission to enable people with cancer to live with dignity, hope and comfort. The organisation provides free-of-cost quality home care services in Delhi and surrounding areas. We support four home care teams to further CanSupport’s mission.
Palcare
Provides home-based multidisciplinary palliative care service for patients, across the length and breadth of Greater Mumbai. In 2021, we supported one of the teams reaching out to patients in East Mumbai.
Karunashraya
Is a joint project of the Indian Cancer Society (Karnataka Chapter) and Rotary Bangalore Indiranagar, for providing free palliative care to cancer patients. We support one ward (12 beds) at the in-patient facility of Karunashraya – a 73-bedded centre that offers holistic multidisciplinary care through both in-patient and home care services.
CanKids KidsCan
Has launched a national ‘Change for Childhood Cancer’ programme with the aim to improve survival outcomes and ensure quality of life for children with cancer and their families by working with state governments. We support this programme in Maharashtra. As part of this initiative, patient navigators handhold the child and his/her family through the cancer journey, providing support with services like accommodation and schooling at ‘CanShalas’ for pediatric patients to continue their education during treatment.
PALLIATIVE CARE TRAINING FOR HEALTH CARE PROFESSIONALS
Building the skills to understand, access and include palliative care into treatment, right from diagnosis
The immense unmet demand for palliative care cannot be served by palliative care experts alone.The solution lies in upskilling health care practitioners to accept and include palliative care into their practice so patients and their families get the holistic care they deserve.
We have partnered with several national and international organisations to run a range of training programmes that are evidence-based and rooted in practice for health care providers.
From April 2020 – June 2021
2,700+
Health Care Practitioners Trained
Click on the tabs to know more about our training courses
NURSES EDUCATION IN PALLIATIVE CARE
ELNEC – End-of-Life Nursing Education Consortium
ELNEC has been developed collaboratively by the American Association of Colleges of Nursing (AACN) and the City of Hope Medical Center, USA. The ELNEC program is adapted for India not only in context but also in structure. It includes regular onsite follow up visits to the institutions where participants practice a two-year mentorship by ELNEC trained instructors.
We have partnered with ELNEC since 2017 to spread nursing education in palliative care across the country. In India, Cipla Palliative Care & Training Centre, Pune has been designated as the main ELNEC training center.
Together with AIIMS, we have taken ELNEC training to 1,870 nurses across India and have 40 ELNEC core trainers
In 2021, we supported new ELNEC trainings at AIIMS in Patna, Lucknow, Siliguri, Udaipur, Goa and Mumbai. Additionally, an online ELNEC programme was piloted with nurses from Kerala and Kolkata. The support to nurses trained in ELNEC in the previous years continued with follow up sessions for nurses in AIIMS as well as the CTCs in Ludhiana, Jammu, Tripura, Assam and Nagaland including pediatric palliative care centers in Mumbai and Chennai.
Online Foundation Course for Nursing Students
This course is designed for BSc and MSc nursing students to give them an orientation to palliative care through interactive case-based discussions and lectures, so that they are aware of palliative care early on in their career. We conducted 4 batches of this course during the year to train 90 nurses and plan to continue this in the coming year.
UPSKILLING PALLIATIVE CARE PROFESSIONALS
EPEC – Education In Palliative And End-of-Life Care, USA4
We have partnered with EPEC based in Northwestern University, USA to bring their training curriculum to India. We are doing this in partnership with the Manipal Academy of Higher Education (MAHE), the teaching hospital of the prestigious multidisciplinary speciality Manipal Hospital. The curriculum has been designed to enable palliative care physicians to become master trainers in palliative care.
40 Physicians Trained In 2020-21
In 2021, we co-hosted a 2-day workshop attended by 40 palliative care physicians across the country that focussed on teaching palliative skills in a virtual world. The other sessions also included self-care for palliative care providers and insights on palliative care service development and advocacy efforts. This workshop was facilitated by the EPEC core team based in USA as well as EPEC India master trainers. We will continue to build on this in the coming year.
IACA – Indo-American Cancer Association – Certificate Course
We have partnered with IACA and Pallium India, TIPS, Trivandrum to conduct a ‘Hands On’ (full time), six weeks certificate course for doctors and nurses. The course is meant for practitioners who have some prior introduction to palliative care and through this course will deepen their theoretical and practical training in palliative care of cancer patients.
Training Update in 2020-21
Due to the pandemic, since we could not offer the course in its residential format, we trained IACA students who were undergoing the course at MAHE, Manipal in five select topics. This included introduction to pain and assessment of pain; nursing issues on prevention of pressure sores and case of stomas; physiotherapy and palliative care.
TRAINING FOR HEALTH CARE SPECIALISTS
We are facilitating training with specialists to upskill them in adopting a palliative care approach in their practice. The aim is to help specialists understand how partnering with palliative care providers can improve lives of patients and their families.
Our Courses Include:
Basics of Pain and Palliative Care with the Indian Academy of Pediatrics (IAP - having 28,000 members across India)
We were entrusted with the responsibility as the academic partner for the first certificate course on ‘Basics of Pain and Palliative Care’ by the IAP. This 12 session online-course introduced 60 pediatricians to adopt a palliative care approach.
Another basic course as well as more advanced course with practical experience is being planned in the year ahead.
IMPACT (Integrated Module of Palliative Care In Cancer Treatment) with the SAARC Federation of Oncologists (SFO)
In January 2021, we launched a unique monthly training programme called IMPACT for health care providers in the oncology space. This training is run in collaboration with the SAARC Federation of Oncologists (SFO) that provides a platform for oncologists in the SAARC region to share best practices.
This 5-hour module, over 2 days, includes sessions from experts in oncology as well as palliative care and covers aspects of pain management, communication, opioid use, addressing emergencies and end-of-life care. We plan to run this monthly programme for a year and then revise content.
ECHO India – Case-based learning for oncologists with Cipla Palliative Care & Training Center, Pune as the hub
ECHO India is a not-for-profit organisation working towards both building capacity and extending access to speciality care for underserved communities.
In 2021, we successfully completed a 9-session ECHO programme with oncologists from Varanasi and Mumbai. The case-based interactive learning makes it possible for professionals to receive practical advice and deepen their skills to provide care for patients. An ECHO for physiotherapists was organized in June 2021 and during the next year more such trainings are being planned for social workers and nurses.
TRAINING FOR GENERAL HEALTH CARE PRACTITIONERS
We have partnered with the Indian Association of Palliative Care (IAPC) – the national umbrella of palliative care organisations in India. We support its core team in ensuring the smooth running of training programmes for palliative care organisations across the country.
We are also one of the recognized IAPC sites to run the Certificate Course in Palliative Care for doctors and nurses. This certificate course helps health care professionals increase their knowledge and skills in palliative care.
It is our endeavour that palliative care is integrated into the curriculum of training. We are furthering our collaborations during the year to work towards this goal.
PUTTING PALLIATIVE CARE INTO PRACTICE
ADVOCACY AND COLLABORATION
Training frontline health care workers in palliative care
Since 2018, we have been supporting a project with the National Health Mission through the Aga Khan Health Services (AKHS) India in 2 blocks, Bhor and Purandar in Pune district.
The aim of this project is to demonstrate the working of community-based palliative care projects, using the recommendations of the Lancet Commission Report that identified 19 symptoms that could be suggestive of patients requiring palliative care.
Training and supervision provided to field health care teams includes:
- Supporting ASHA workers to identify patients, based on the checklist of symptoms and refer them to the nearest health facility
- Enabling medical officers, nurses and multi-purpose workers at the primary health care, rural and district hospitals to treat pain, symptoms and ensure a stock of essential medicines
- Developing a referral mechanism for patients with more complex needs
- Community awareness about palliative care and working with the local Self Help Groups
Around 290 ASHA workers have been using the checklist of symptoms.
Over 1,500 patients have been identified as requiring palliative care and referred to health facilities.
An end-line study is currently being undertaken to evaluate the impact of the project which will be published by August 2021. These learnings will help us develop a plan of action to expand grassroots access to palliative care and present this to the National Health Mission to scale up across the state.
ASHA HAMESHA CAMPAIGN
With the hope of making early palliative care a reality, we launched the ASHA HAMESHA campaign on World Cancer Day 2021.
We organized an informative round table, led by Dr Y K Hamied, about the barriers and practical solutions for making early integration of palliative care possible in cancer treatment. Some of the most effective ways to create change that emerged were – learnings from existing successful models, exploring collaborative ways of working and scaling up training.
“There are 3 key elements for effective early palliative care – community partnership in care; a palliative care approach by all health care providers; and specialised palliative care professionals at the top of the pyramid.”
Dr MR Rajagopal
Pallium India
“There is inadequate exposure to palliative care in oncology training and a handful of MDs in palliative care. The leadership at cancer centres in India needs to take responsibility for early integration. ”
Dr CS Pramesh
Tata Memorial Hospital
“Our yardstick has now changed from just survival to improved quality of life. Our doctors have to understand that palliative care is an integral part of cancer care.”
Dr Anil D’Cruz
Union of International Cancer Control
In January 2021, we conducted an online survey with 200 oncologists across India which revealed that they recognize palliative care as a multidisciplinary approach to patient care.
However, the lack of awareness among patients and caregivers and the lack of trained personnel in palliative care were cited by them as barriers for early integration of palliative care into oncotherapy.
We brought different voices together by holding and participating in webinars and panel discussions to build awareness about palliative care and its early integration.
We engaged with organisations like the Indian Medical Association Pune chapter, SAARC Federation of Oncologists, Indian Cancer Society, Delhi, Indore Cancer Foundation and Aastha Foundation, Pune.
CARING IN COVID
The gates to Cipla Palliative Care & Training Centre remained open and so did our hearts.
The pandemic has changed our world but guided by stringent Covid safety protocols, our team has continued to care for patients and their loved ones with the same spirit.
We developed standards of care to help us monitor the quality of our service. Each team has a checklist of indicators that are reviewed on a monthly basis to ensure that we continue to provide high quality care to all our patients.
From April 2020 – June 2021
10,800+
Free-of-cost consultations provided
2,300+
Home care visits done
4,000+
Teleconsultations done
“As difficulties rose in Covid, we strengthened our resolve to keep caring for our patients in the face of every challenge. It has not been easy, but we have been helping patients and their caregivers battle the fear of infection, loneliness and lack of access to continued care – all this, while taking every precaution to keep them and our team safe in the pandemic.”
Dr Vivek Nirbhawane
Head, Clinical Services, Cipla Palliative Care & Training Centre, Pune
CPC – CARING WITHOUT A PAUSE
24/7 IN-PATIENT SERVICES
CPC never stopped admitting patients and their families in the pandemic.
Stringent Covid safety precautions and protocols are being followed. The team has also been running Covid awareness sessions to ensure adherence to all guidelines.
HOME CARE SERVICES
After a brief pause of a few weeks, we re-started home care services in April 2020 to serve critical patients in the comfort of their homes.
This has since continued without a pause and brought much-needed care to patients and their families in the lockdown.
TELECONSULTATIONS
We have been serving patients through audio and video calls for medical support, physiotherapy, diet assistance, psychosocial and other support such as linkages with general physicians in times of emergencies.
In the lockdown, this service was needed, more than ever.
MEDICINE DROP OFFS
During lockdowns, we continued to home deliver medicines to our patients undergoing treatment.
We ensured that access to their essential medicines was not interrupted even in the most difficult time.
RATION SUPPORT
We have been providing dry ration and other essential items to patients and their families who were left stranded in their homes due to lockdowns and to those facing financial hardships.
FINANCIAL SUPPORT
Our unique patient-support program SAHYOG has been launched to ease the financial burden on patients in Covid.
The program is publicised at government and charitable hospitals in Pune.
CAN-HELPER
India’s first-of-its-kind toll free emotional helpline
Don’t let COVID take attention away from Cancer
CAN-HELPER is here
Toll-free: 09511948920
CAN-HELPER
India’s first-of-its-kind toll free emotional helpline
Don’t let COVID take attention away from Cancer
CAN-HELPER is here
Toll-free: 09511948920
Cancer patients and caregivers are experiencing heightened anxiety, fear and a higher symptom burden due to inability to reach health facilities in Covid.
To support these patients and their families, in August 2020, together with Tata Memorial Hospital, we set up CAN-HELPER – India’s first-of-its-kind toll free helpline to support cancer patients and their families in Covid.
Experienced counsellors and volunteers from Tata Memorial Centre, Mumbai and the Cipla Palliative Care & Training Centre, Pune, who run the helpline, are supporting patients and families, to ensure that the most vulnerable patients are cared for, comforted and that their emotional pain is reduced.
OUR PALLIATIVE CARE PARTNERS IN ACTION IN COVID
Click on the image to know more
Bringing care to patients, cut off in hard-to-reach locations and remote villages
Dr B BOROOAH CANCER INSTITUTE, GUWAHATI
Driving hope to caregivers by delivering medicines to their doorstep
CANSUPPORT, NEW DELHI, MEERUT, BHATINDA
Ringing in celebrations when Covid threatened to take all cheer away
CSM HOSPITAL, KALWA, THANE
Helping patients fill their moments of isolation with colours of care
CANKIDS KIDSCAN, DELHI
Taking the time to comfort elderly patients with heart-to-heart conversations
PALCARE, MUMBAI
Meeting patients and caregivers in lockdowns with Covid safety precautions
INDORE CANCER FOUNDATION, INDORE
Filling pediatric wards with love and laughter – Monica the clown, with her happy mask on
BJ WADIA HOSPITAL FOR CHILDREN, MUMBAI
Reassuring children and their parents that care will go on, as before
ROMILA PALLIATIVE CARE, MUMBAI
Helping patients find peace and calm amidst the chaos of Covid
KARUNASHRAYA, BENGALURU
OUR WAY AHEAD
Growing together from strength to strength
We are committed to integrating palliative care into treatment protocols, right from diagnosis – to make a real difference in the lives of patients and their families.
To realize this vision, we have been building Cipla Palliative Care & Training Centre (CPC) as a Centre of Excellence in service delivery, training and research. With CPC as our anchor, we will continue to strengthen partnerships with like-minded organisations to take palliative care services across the country. We will strive to grow our ongoing efforts in training health care providers, advocating for collaborative action and growing evidence through research.
1. Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report, 2017
2. Connor SR, Downing J, Marston J. Estimating the global need for palliative care for children: A cross-sectional analysis. J Pain Symptom Manage. 2017;53:171-7
3. The CTC Training Program, implemented by (AIIMS) is in collaboration with the Asia-Pacific Hospice Palliative Care Network (APHN) funded by the Lien Collaborative, is designed for a team consisting of 2 doctors and 2 nurses from each CTC, with the aim to integrate palliative care early in diagnosis.
4. The Education in Palliative and End-of-Life Care program at Northwestern University Feinberg School of Medicine was created with the support of the American Medical Association and the Robert Wood Johnson Foundation and updated with the support of the Coleman Foundation.