Business and Practice Management
An ageing population, rising comorbidities, and a growing preference to die at home are driving an increased need for accessible, community-based palliative care services.
Primary care professionals are essential to helping meet this demand, yet many feel challenged by the complex funding and support arrangements that exist to help navigate palliative care delivery in primary care settings. [1]
In this section of the Toolkit, you can find information and guidance on how to enhance the delivery of palliative care in primary care from a business and practice management perspective.
Getting started
Palliative care can be provided in various locations, including:
- anywhere a person identifies as being their home
- at a specialist palliative care unit or hospice
- in a hospital
- in a residential aged care facility.
Many Australians prefer to die at home, however only a small percentage do so. Primary care professionals will often need to undertake home visits to care for older persons receiving palliative care, as they might not be physically able to attend the practice.
To improve the efficiency of home visits, consider:
- Scheduling home visit appointments at the most appropriate time to reduce unnecessary travel or delays.
- Setting up a clear communication process with the older person, their family and carer(s), and the residential aged care facility before the visit.
- Establishing a home visit policy and procedure which addresses potential safety concerns and other clinical governance arrangements.
Home visits
GPs and palliative care: Frequently asked questions
Royal Australian College of General Practitioners (RACGP)
Home-based palliative care
Reymond L, Parker G, Gillies L, Cooper K. Home-based palliative care. Australian Journal of General Practice. 2018;47(11): 747-752. doi: 10.31128/AJGP-06-18-4607
Checklist - Planning for a home death
CareSearch
Residential aged care visits
Advice for GPs with patients in aged care (236kb pdf)
Western Victoria PHN
‘Hide and seek’ a barrier to GPs visiting residential aged care facilities
University of Wollongong
Delivering palliative care and end-of-life care requires working as a multidisciplinary team to provide integrated care across services to meet the evolving palliative care needs of the older person.
Those with less complex needs may be managed in the primary care setting. Other people may have shared care arrangements, with palliative care provided in a collaborative manner between the GP and/or specialist, and the specialist palliative care service. People with more complex needs should be able to access care provided by specialist palliative care services.
The role of the primary care professional in the team will therefore depend on the older persons’ palliative care needs. You can read more about ‘What is my role as a primary care professional in Working Together?’ in the Work Together section of this toolkit. Working across sectors and professions can be a challenge to delivering quality palliative care. To improve the efficiency of working with other health professionals and providers, ensure there are structures and plans in place for:
- care coordination
- case conferences
- sharing information.
Commonwealth, State and Territory government and Primary Health Networks (PHNs) have developed resources, programs or initiatives to support primary care professionals in the delivery of palliative care.
This toolkit utilises the free resources available and will promote the many programs, courses and initiatives relevant to palliative care and advance care planning provision.
Some run education and training events, others offer practice visits and coaching opportunities, and much more.
To ensure you are aware and can utilise these opportunities, keep up to date with: