COVID-19 has caused both destruction and disruption on an unprecedented scale.
There has been destruction of lives and livelihoods. And while there has also been extraordinary disruption in the classical sense of the word, there has also been a disruption in the more modern meaning: when new approaches and innovations emerge and shake up the traditional way of doing things. The virus has created new opportunities to support each other as a community, new ways of connecting with family and - for the health and aged care sectors – new ways to build the capacity of systems and to foster collaboration at speeds that have dazzled many.
The implementation and consultation of new telehealth items has occurred at warp speed, with some declaring that what looked like a ten-year project had been accomplished in weeks. This has been achieved because we have all come together like never before.
In early March, as the full threat of COVID-19 loomed in Australia, our palliative care sector was already taking measures to prepare for increased numbers of people dying from COVID-19 and to support health professional colleagues who may not have had experience of caring for patients dying in the way experienced by COVID-19 patients overseas.
The sector began to think strategically about the needs of existing palliative care patients and the palliative care workforce and what resources would be required to ensure palliative care patients and their families continued to receive the care and support they need.
As part of this planning, Palliative Care Australia (PCA), the national peak body for palliative care, brought together experts in a range of palliative care disciplines including clinical, academic, research, policy and advocacy. PCA Chair Professor Meera Agar, clinician, academic and advocate for palliative care, was able to rapidly bring together key leaders on the national level and also engage proactively with State and Territory palliative care clinicians. With its first meeting on 3 March 2020, the Australian COVID-19 Palliative Care Working Group (ACPCWG), chaired by Professor Agar, was formed and has been meeting weekly via Zoom since then.
The Working Group established an issue register early on, which enabled critical issues to be identified quickly for consideration. Using their wide breadth of expertise, the Working Group has undertaken and supported a range of activities including:
- Providing a conduit of advice to the Australian Government and a point of dissemination of key messages to the palliative care community
- Supporting the development of clinical guidance about COVID-19 and palliative care undertaken by ANZSPM
- Advising the Therapeutic Goods Administration on critical palliative medications and devices for inclusion on the ‘watch-list’
- Publishing statements, commentaries and opinion pieces
- Supporting and making submissions on measures to improve telehealth through the MBS for palliative care patients
- Publishing a dedicated e-newsletter
- Supporting CareSearch’s establishment of a COVID-19 resource centre for across the system and population
- Contributing to valuable webinars for aged care staff (ELDAC)
- Promoting packs for palliative care patients being cared for in the home (caring@home),
- Joining the National COVID-19 Clinical Evidence Taskforce and support the creation of a palliative and aged care panel
The Working Group has also been concerned with the health and well-being of patients and staff in residential aged care, including visitor access for palliative care patients and the storage and access of palliative care medications.
The crisis is not yet over. However, whatever happens now with the course of COVID-19 in Australia, the country can be assured that palliative care leaders are ready to support anyone who needs palliative care, when and where they need it.
Most heartening, perhaps, has been the fact that, at key levels of government, palliative care has been included as central to the pandemic response. The importance of ensuring people have access to the care they need and the chance to die with dignity is our priority – “opportunity” may not be the right word, but COVID-19 has certainly provided an impetus to improve palliative care and collaborative working in Australia.
Moving forward, the Working Group is looking at ways it can embed some of the positive changes that have occurred – most immediately though submissions to the Aged Care Royal Commission and the current COVID-19 Senate select committee – so that the positive changes that have occurred are enduring, and not fleeting.
Rohan Greenland, CEO, Palliative Care Australia