Palliative care is not yet seen as a medical speciality in all countries. However, modern nursing and clinical training usually includes some introduction to palliative medicine and palliative care. Modern HIV care is a multiprofessional discipline, and members of the team should have the basic skills of holistic care required to meet basic palliative care needs. Intractable symptoms, anxiety and psychosocial/spiritual crises associated with incurable disease, and terminal care may all present challenges to the care team that require consultation with specialist palliative care staff. Clear referral guidelines are extremely helpful in identifying those patients who may benefit from specialist input. The availability of palliative care training to the HIV care team, as well as established named links to specialist palliative care, are important steps to ensuring that patients can access the care they need.

Palliative care may be provided in a number of settings:

• In patient hospital care
• Nursing homes
• Outpatient clinics
• Primary care settings
• In patients’ homes
• Hospices

It may be provided by specialist voluntary-sector funded services such as Macmillan nurses, Marie Curie nurses or hospice staff, or by statutory sector hospital-based palliative care services and trained General Practitioners.

The palliative care model is strongly multiprofessional, and may include:

• Doctor
• Nurse
• Social worker
• Physiotherapist
• Welfare benefits adviser
• Occupational therapist
• Art therapist
• Music therapist
• Aromatherapist
• Dietician
• Counsellor
• Religious/spiritual advisor