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Literature suggests that integrated palliative care (IPC) increases the quality of care for palliative patients at lower costs. However, knowledge on models encompassing all integration levels for successfully implementing IPC is scarce. The purpose of this paper is to describe the experiences of IPC leaders in seven European countries regarding core elements, facilitators and barriers of IPC implementation and provides recommendations for future policy and practice.

A qualitative interview study was conducted between December 2013 and May 2014. In total, 34 IPC leaders in primary and secondary palliative care or public health in Belgium, Germany, Hungary, Ireland, the Netherlands, Spain and the UK were interviewed. Transcripts were analysed using thematic data analysis.

IPC implementation efforts involved a multidisciplinary team approach and cross-sectional coordination. Informal professional relationships, basic medical education and general awareness were regarded as facilitators of IPC. Identified barriers included lack of knowledge about when to start palliative care, lack of collaboration and financial structures. Recommendations for improvement included access, patient-centeredness, coordination and cooperation, financing and ICT systems.

Although IPC is becoming more common, action has been uneven at different levels. IPC implementation largely remains provisional and informal due to the lack of standardised treatment pathways, legal frameworks and financial incentives to support multilevel integration. In order to make IPC more accessible, palliative care education as well as legal and financial support within national healthcare systems needs to be enhanced.

This chapter looks at the discursive dimension of the working environment in research and higher education organizations; more specifically at neoliberal managerial discourse and at how it participates in shaping the way researchers, teachers and support staff perceive themselves and their experiences. It is based on a multiple case study and combines an intersectional and a socio-clinical approach. The empirical data is constituted by in-depth interviews with women conducted in Ireland and Chile, and includes some observations made in France. A thematic analysis of individual narratives of self-ascribed experiences of being bullied enables to look behind the veil drawn by managerial discourse, thus providing insights into power vectors and power domains contributing to workplace violence. It also shows that workplace bullying may reinforce identification to undervalued social categories. This contribution argues that neoliberal managerial discourse, by encouraging social representations of “neutral” individuals at work, or else celebrating their “diversity,” conceals power relations rooting on different social categories. This process influences one’s perception of one’s experience and its verbalization. At the same time, feeling assigned to one or more of undervalued social category can raise the perception of being bullied or discriminated against. While research has shown that only a minority of incidents of bullying and discrimination are reported within organizations, this contribution suggests that acknowledging the multiplicity and superposition of categories and their influence in shaping power relations could help secure a more collective and caring approach, and thus foster a safer work culture and atmosphere in research organizations.