The road ahead for primary care in supporting Australians at the end of life
A guest blog from Suzzie Harvey, Director, Business Development, Australian Healthcare and Hospitals Association
The COVID-19 pandemic over the last few years has stretched the healthcare workforce, and the aged care sector is finding it increasingly difficult to attend to the needs and wishes of older Australians. The demand for palliative care is only going to increase, with the estimates of a 50% increase from 2020 to 2035[1]. The role of primary care in addressing the health needs of older Australians, particularly at end-of-life, is fast becoming increasingly vital.
As the cornerstone of primary care, general practice and general practitioners (GPs) can provide a smooth transition from chronic disease management to treatment of advanced illness, palliative, and end-of-life care. As our ageing population grows and people’s wishes to be cared for and to die at home increases, the demand for palliative care management in primary care has also increased. When looking at key resources in the palliative care landscape, they all highlight the need for the improved delivery of integrated, generalist palliative care in the primary care setting.
Most Australians have an expectation that their GP will be able to provide them with the care they need when they are unwell, or at least make sure that they are linked in with the right services. While most GPs feel they have a role to play in caring for patients at the end-of-life, many do not feel confident in doing so.
A recent roadmap for palliative care released by Palliative Care Australia[2], highlights that supporting and growing the skills and knowledge of the primary care workforce in palliative care is essential to ensuring the delivery of high-quality end-of-life care for all who need it, where and when they need it.
It recognises that GPs play a key role in a patient’s care journey. GPs are well-placed to establish palliative care for individual patients who remain in their home or in residential aged care, to coordinate care across the health system, and collaborate with other healthcare providers.
The National Palliative Care Strategy 2018[3] (the Strategy) highlights general practice and primary care as key to the person-centred support required by those affected by life limiting illnesses. ‘Goal 2: Capability’, in the Strategy, states that knowledge and practice of palliative care is embedded in all care settings but also highlights that the World Health Assembly recognised that here is an ‘urgent need to include palliation across the continuum of care, especially at the primary care level, recognising that inadequate integration of palliative care into health and social care systems is a major contributing factor to the lack of equitable access to such care.’
By providing high quality, appropriate palliative care and advance care planning support, primary care providers can play a significant role in helping their patients to both live and die well and according to their wishes.
The ELDAC Primary Care Toolkit addresses some of the workforce needs identified in both The Palliative Care Strategy 2018 and the Australian Palliative Care Roadmap 2022-2027. It can guide primary care providers and teams through the steps in providing palliative care and supporting advance care planning with patients and their families. In addition, the ELDAC Primary Care toolkit will support general practices to develop capabilities in the provision of continuous and comprehensive care relating to palliative care (aligning with Criterion GP2.1 of the RACGP standards for general practice)[4].
The ELDAC Primary Care Toolkit contains:
- Links to clinical tools and resources;
- Education, training, and quality improvement strategies for palliative care and advance care planning;
- Information on how to access and develop local HealthPathways; and
- Resources to improve coordination and cooperation between services and providers.
References
- KPMG analysis based on KPMG and PCA (2020), Investing to Save: the economics of increased investment in palliative care in Australia.
- Palliative Care Australia (2022), Palliative Care Australia Roadmap 2022-2027.
- Australian Government (2018), The National Palliative Care Strategy 2018, Department of Health.
- The Royal Australian College of General Practitioners (2017), Standards for general practices, 5th edition.
Suzzie Harvey
Director, Business Development, Australian Healthcare and Hospitals Association