Elderly and Palliative Care transformation – a WHO/NHS England Collaboration 

As the population ages in North Macedonia, family structures are changing. The healthcare system and the social support networks have limited capacity to provide integrated and person-centred care, leaving older people in the country facing a number of health, social, and economic challenges.  

NHS England and WHO EURO supported the design and implementation of a feasibility study on transforming the ‘13th November’ hospital, which currently has capability for specialisation in geriatric and palliative care. This study provided a basis for a transformational programme of work to develop an educational centre for the newly designed geriatric sub-specialization.  

Data was collected for this study during an in-country mission to North Macedonia. Key recommendations were developed in this study to take forward the sub-specialisation in elderly care.  

As a result of this study, NHS England and the WHO EURO are working closely with the Medical Faculty to develop an action plan, using the recommendations, to transform the specialized geriatric and palliative care hospital into an educational centre for the newly designed geriatric sub-specialization. This action plan was discussed at the National Workshop in a second in-country mission to North Macedonia in June 2022, and validated by key stakeholders.  

Image of process flow
Phase 1
1. Completion of a situational analysis / literature review about geriatric and palliative care and the identified hospital
2. Country mission and data collection
3. Recommendations based on the NHS England quality framework analysis
Phase 2
4. Recommentdations transformed to action plan
5. Completion of a situational analysis about quality of geriatric and palliative care in North Macedonia as a country 
6. Second country mission, data collection and workship examining options around workforce transformation in North Macedonia
7. Roadmap for improving the quality of care in North Macedonia as a country
8. Proposed Phase 3 to go into more depth

Currently, NHS England is developing a roadmap to develop a quality framework for older people in care in North Macedonia. 


If you or your organisation are interested in collaborating with us, or would like more information on our consultancy services, then please do not hesitate to get in touch. We would be very happy to hear from you! Our email address is: england.tcc@nhs.net