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Palliative Care Needs Assessment Framework

Late referral, crisis referral, non-referral or unnecessary referral can all potentially affect the quality of life of patients and their carers. There is currently a lack of national agreement around when it is appropriate to refer and what are the appropriate reasons or triggers for referral to specialist palliative care services.

The Centre for Health Research & Psycho-oncology (CHeRP) at the University of Newcastle has developed and disseminated needs assessment guidelines and a needs assessment tool for the appropriate referral of cancer patients to palliative care services. The Palliative Care Needs Assessment Guidelines are designed to provide information to assist decision making and are based on the best evidence available at the time of publication. Used in both generalist and specialist settings to support the recommendations in the Guidelines, the Needs Assessment Tool: Progressive Disease – Cancer (NAT: PD-C) can assist in matching the types and levels of need experienced by people with advanced cancer and their caregivers with the most appropriate people or services to address those needs.

Evaluation

An evaluation was conducted to assess the impact of the introduction and systematic use of the Guidelines and NAT: PD-C on the needs and service utilisation of people with advanced cancer and their caregiver.

Impact on patient outcomes

  • Can assist health professionals to identify and address any problems patients had with:
    • health system and information (eg information, access to services, resources, treatment centre environment)
    • patient care and support (eg choice of specialist & hospital, reassurance, prompt attention to needs).
  • Identifying and addressing issues as they arise can minimise the expected worsening of physical and daily living needs and quality of life associated with progressing disease.

Impact on service utilisation and referral

  • Can assist busy clinicians to efficiently identify issues of concern, particularly in areas that are not routinely well addressed such as psychosocial issues.
  • In the majority of cases, the issue of concern identified can be managed by the health professional completing the NAT: PD-C or someone from their care team.
  • Has a high rate of completion (83%) by a range of health professionals
  • Completion does not create additional burden in terms of consultation length.

Reliability, validity and clinically feasible

  • Reliable, valid and clinically feasible when tested in a clinical setting with people with advanced cancer.

Overall, the routine, systematic and regular use of the Guidelines and NAT: PD-C in a range of clinical settings can facilitate the timely provision of needs based care, including palliative care, especially in primary care and the services that refer to palliative care.

Last updated on 27 November 2012