‘Road·tripping’-taking specialist palliative care consultancy on the road

Palliative care services have developed mainly in metropolitan settings. Typically to date, rural areas have been characterised by a lack of specialist services with primary care professionals, usually general practitioners and community nurses, providing palliative care. Often those patients with complex psycho-social needs are those in the most isolated settings. Undertaking to improve this regional service, since 2009 the Gippsland Region Palliative Care Consortium has accessed the services of the Peninsula Health palliative care team, with a physician and counsell or visiting six sites in south Gippsland every month. The team has been utilised in a variety of ways, including reviews at home and in hospital, participation in MDT and education meetings, telephone and electronic support and debriefing around complex cases, both on a group and individual basis. We have undertaken a qualitative review of this service looking mainly at the response of primary care providers. Themes emerging include management of complex pain and symptom control, better education opportunities and psychological benefits especially around bereavement counselling. Facilitation of prior difficulties in accessing specialist palliative care units and opportunity for local outpatient reviews in tandem with the treating oncologists has also made a significant difference to the rural patient population.