A model for community palliative care in Gippsland Part 1 – Report

The Gippsland Regional Palliative Care Consortium (GRPCC) commissioned this project to help community palliative care services meet the challenge of increasing demand. The purpose of the project is to support capacity building through the development of a model that may be adopted by services region-wide and is based on the national standards. It is intended that the model be adapted for local environments.

There are nine funded specialist community palliative care services in Gippsland and there is variation in how they provide palliative care. An overview of their practice was obtained through extensive consultation with six services and other stakeholders.

The participating services were:

• West Gippsland Healthcare Group;
• Bass Coast Community Health;
• Bass Coast Regional Health;
• Bairnsdale Regional Health Service;
• Gippsland Lakes Community Health; and
• La Trobe Community Health Service.

The main findings were:

• district nurses (DNs) and general practitioners (GPs) have historically been responsible for the palliative and end-of-life care of clients at home;
• in recent years the core teams of DNs and GPs have been augmented by a nurse practitioner (NP), nurse practitioner candidates (NPCs), palliative medicine specialists (specialists), volunteers and allied health (AH) professionals;
• the standard of palliative care has significantly improved and there is a great commitment to learning and improving outcomes for clients;
• some services are participating in the Palliative Care Outcomes Collaboration (PCOC) and the National Standards Assessment Program (NSAP) but lack of electronic support prevents benchmarking;
• many DNs have undertaken short courses in the palliative approach but few have post graduate qualifications in palliative care;
• a range of AH practitioners is available but their full potential in palliative care is not being realised;
• multidisciplinary care is generally not well integrated; and
• innovative initiatives are not widely recognised.

This report is linked with the model and includes recommendations to:

• optimise current resources;
• support DNs to achieve post graduate qualifications to achieve a critical mass of specialist expertise;
• appoint a DN to liaise between community and inpatient settings and actively develop relationships within the multidisciplinary (MDT) team to promote seamless and holistic care;
• integrate client notes and care plans;
• ensure robust collection and reporting of data; and
• publicise innovation and expertise.

Areas that are covered through other GRPCC programs and not addressed in detail in this project include:

• After-Hours Palliative Care Support;
• Nurse Practitioner Program;
• Specialist Palliative Care Consultancy Service;
• Palliative Aged Care Link Nurse Project;
• Palliative Care in Disability Accommodation Services; and
• volunteers.

A Model for Community Palliative Care in Gippsland   Part 1 - Report (1.49MB pdf)