- Why is this measure important?
- What is the aim of the measure?
- What are the objectives of the measure?
- Who will be affected/What is the target population?
- What will guide the implementation of the measure?
- What is the level of funding for the measure?
- How it will work?
- What is the evidence base for this approach?
- Who can I contact if I have questions?
1. Why is this measure important?
- The Government has designed this initiative to address a clearly identified need for people requiring palliative or end-of-life care, and their families and carers.
- Australia has one of the lowest rates in the world of people dying outside of hospital or in residential aged care.
- Provided that symptoms can be adequately controlled, up to 90 per cent of people at the end of life prefer to be cared for and to die comfortably at home. Cost-effective care will support patient preferences at the end of life.
- Chronic diseases including cancer and dementia are the leading cause of illness, disability and death in Australia, accounting for 90 per cent of all deaths in 2011, with 5.3 million Australians living with two or more chronic conditions.
2. What is the aim of the measure?
The primary aim of the Greater Choice for At Home Palliative Care measure is to provide funding to improve coordination and integration of end-of-life care across primary, secondary, tertiary and community health service to support at home palliative care through funding Primary Health Networks (PHNs)
3. What are the objectives of the measure?
The Greater Choice for At Home Palliative Care measure will:
- improve access to safe, quality palliative care at home and support end-of-life care systems and services in primary health care and community care;
- enable the right care, at the right time and in the right place to reduce unnecessary hospitalisations;
- generate and use data to ensure continuous improvement of services across sectors; and
- utilise available technologies to provide flexible and responsive care, including care after usual business hours.
4. Who will be affected/What is the target population?
The target population for the measure is individuals with a known life-limiting condition and their families. Increasingly individuals with chronic conditions – including cancer – are being referred to palliative care alongside their chronic disease management in community settings.
5. What will guide the implementation of the measure?
Informed by the goals of the National Palliative Care Strategy, the following principles will guide the implementation of the measure:
- Care will be person centred; this includes family and primary care providers and is responsive to cultural and individual needs.
- Activities to be designed with consideration of models of care, where the focus is not just on mapping of clinical pathways, but also on identifying patients that may benefit from early engagement with palliative care and mapping their formal and informal networks and building community capacity to support people at the end-of-life.
- Underpinned by inclusive community approaches, such as Compassionate Communities, to enhance the informal care networks of people requiring palliative care, and identify ways to connect both the formal health care services, information and social supports.
- Service redesign and models of care will be based on best available evidence. The measure will be underpinned by data, benchmarking and a continuous quality improvement process to inform the national evaluation.
- Implementation will be underpinned by service and organisational integration.
- Equity of access will ensure that all members of the targeted communities, including people from vulnerable population groups are able to access services.
- Carers have a unique role in supporting someone at the end of life. The importance of their role and need for support before and after death will be acknowledged and respected.
6. What is the level of funding for the measure?
- The Government has provided $8.3 million over three years (from 2017-18 to 2019-20) to boost funding for palliative care coordination through PHNs to support people who have a known life-limiting condition by improving choice and quality of care and support.
7. How it will work?
Consistent with current practice:
- PHNs will be required to work collaboratively with State and Territory governments including the relevant local hospital network (or equivalent), aged care providers and community services to meet agreed objectives and performance indicators.
- Specific models of care coordination will be based on assessment of existing and regional population needs, be placed based and tailored to suit the requirement/needs of each community.
- For some PHNs implementation may involve coordinated commissioning approaches with the local health/hospital network to implement home based palliative care.
- Clear governance, communication and accountability frameworks, such as MOUs have been shown to facilitate care-coordination and service linkage.
8. What is the evidence base for this approach?
There are seven key strategies that promote organisational linkages:
- Multidisciplinary team structures
- Written and verbal communication pathways
- Formalised agreements and plans
- Designated linkage worker (funded coordinator role)
- Role clarification
- Knowledge exchange and up skilling
- Continuous improvement (funded monitoring and evaluation role)
See Linkages project case studies under related resources for the evidence base for this approach
9. Who can I contact if I have questions?
If you have any questions in relation to the measure, please send an email to the Department of Health - Palliative Care inbox at Palliative.email@example.com