Peak Body Welcomes Framework to Allow Terminally Ill to Die at Home

The peak body for palliative care has welcomed a “visionary” new framework to help more people with a terminal illness die at home in Victoria.

The new End-of-Life and Palliative Care Framework, which was announced by the Victorian minister of health, Jill Hennessy, on Thursday, will overhaul the current “outdated” system.

As part of the initiative, the state government has committed $7.2 million to fund the expansion of specialist palliative care expertise, training for GPs, additional respite services, and carers training and support.

Palliative Care Victoria chair Dr Judi Greaves said the plan recognised that end of life care was very important.

“This visionary and ambitious plan recognises that end of life care is very important to all Victorians and that we need to re-design and strengthen our services to meet community expectations and growing demand much more effectively,” Greaves said.

“Palliative Care Victoria strongly supports the vision, goals and directions outlined in the framework. Achieving these at a practical level will require significant innovation and collaboration, supported by investment that will ultimately deliver better outcomes more effectively and efficiently.”

The framework, which follows extensive community consultations, aims to provide the best palliative care and end of life care in ways that are tailored to each person’s needs and preferences.

Greaves said it was important the framework recognised that achieving this goal was “everyone’s business”.

“It starts with engaging communities and encouraging individuals to discuss their end of life care wishes. It also means all relevant health and care staff in a broad range of services across Victoria must have the skills needed to contribute to high quality palliative care and end of life care,” she said.

“We welcome the proposed strategies to strengthen the availability of specialist palliative care expertise and consultancy across Victoria, to improve support for carers, to develop effective and efficient home-based models of care and to support valued community contributions by volunteers.

“The framework provides a clear set of goals and priorities that will help to guide service innovation and better integrated and coordinated services. We also welcome the commitment to measure progress and ensure greater transparency about how well our services are meeting community needs and aspirations into the future.”

According to the Labor government, currently, only 14 per cent of Australians who want to die at home are able to, and the new framework forms part of their plan to change that.

The key aspects of the Framework include:

• delivering person-centred services
• engaging communities and embracing diversity
• co-ordinating and integrating services
• standardising home based models of care to ensure quality and safety is assured
• making quality end-of-life and palliative care everyone’s responsibility
• strengthening specialist palliative care.

As part of this plan, a new home based model of care will be trialled through a partnership project between hospitals, aged care community palliative care and Primary Health Networks before being rolled out across the state.

The framework has also incorporated relevant recommendations from the Parliamentary Committee Inquiry into End-of-Life choices, and the government said it will provide a full response to the Inquiry in due course.

Hennessy said the framework reflected the views and hard work of many people in the community

“All Victorians deserve access to the best possible end-of-life care which relieves pain and suffering and supports families and carers in their last days,” Hennessy said.

“This is about ensuring we have a proper model-of-care in place that will increase the options for people dying at home in an environment that is medically safe, compassionate and supportive for patients and their families.

“This framework reflects the views and hard work of many people in the community, and gives a real voice to families and carers.”

However, Palliative Care Victoria chief executive officer Odette Waanders told Pro Bono Australia News there was a “disjunction” between the funding and the vision outlined in the framework.

“It is a 6 per cent increase on current funding levels which is disappointing,” Waanders said.

“It is less than 50 per cent of what Palliative Care Victoria was hoping would be allocated as a minimum. And I think what that says is that there will need to be significant injections in funding in the forward years if the government is going to achievement the vision outlined in the plan.

“Because they’re really looking at significant innovation in service delivery, at a time when the enquiry has indicated the palliative care sector is over burdened and needs more support from government. So clearly they haven’t been able to allocate the amount of funding that is really needed in this financial year but we would hope that that would be forthcoming in the future.

“It is a visionary and ambitious plan and we are very supportive of the framework… what we are really seeing is there is a bit of a disjunction between the vision and ambition in the framework and the funding that has been allocated to achieve it, and that is disappointing.”

Waanders said investment in palliative care was a “win win”.

“What we have always said in our call to action, and there is a lot of evidence to support this, is that investment in palliative care is a win win,” she said.

“It improves the quality of life of people facing the end of life and their families, but it also results in much more effective use of health resources.

“So it is actually an important contributor to better outcomes overall for the health system if there is adequate provision of high quality palliative care and end of life care, and when you don’t have those things, you actually end up spending a lot more on health but with much poorer outcomes.”