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The views and opinions expressed in our blog series are those of the authors and are not necessarily supported by CareSearch, Flinders University and/or the Australian Government Department of Health.
The Adelaide Primary Health Network has been meeting with stakeholders in the provision of palliative care since the commencement of our organisation in July 2015. We have always seen palliative care as a priority and have been working closely with providers through our Older People and Palliative Care Health Priority Groups. In fact, it was with their help that we were able to submit an expression of interest when the Commonwealth offered funding for the Greater Choice for At Home Palliative Care measure. So, it is with great pleasure that in February 2018, the Adelaide PHN was selected as a successful recipient of funds through the Greater Choice for At Home Palliative Care measure.
The Commonwealth Government are providing $8.3 million over three years (from 2017-18 to 2019-20) to implement the Greater Choice measure in 10 PHNs. The selected PHNs receive funding to employ two Full-Time Equivalent positions to support people who have a known life-limiting condition by improving choice and quality of care and by improving coordination and integration of palliative care across primary, secondary, tertiary and community health services.
The Adelaide PHN will utilise its funds through Enabling Choice for South Australians to address issues identified though our needs assessment processes which are undertaken regularly with key stakeholders. These processes identified inconsistencies in the use of advanced care planning tools and information, a need for greater staff support, on-the-job mentoring or coaching around end of life care planning and a lack of understanding in the community about the importance of end-of-life care planning and its capacity to support greater choice. In addition, a lack of data and collection mechanisms have made it difficult to determine the effectiveness of existing tools and resources. The Enabling Choice for South Australians project has been designed around the development of quality improvement indicators and the provision of consistent messages and resources to ensure more people know about and access palliative care in the community.
The Adelaide PHN’s Enabling Choice for South Australians project, using a model of organisational capacity building, will work closely with aged care service providers and other stakeholders to support continuous quality improvement based on best practice guidelines. Organisational capacity building encourages the strengthening of human resources and management systems, which in turn supports the development of an environment where these skills and attitudes can be maximised. The learnings gathered through the Enabling Choice project will be shared across primary and secondary sectors to support ongoing improvement. An inter-sectoral collaboration group will support the project and ensure learnings are shared.
Figure 1. Enabling Choice for South Australians model
Based on the above model, our project aims to build on the extensive resources and programs which are already available, such as CareSearch, End of Life Directions for Aged Care (ELDAC) and the Program of Experience in the Palliative Approach (PEPA). The project will also draw from the National Consensus Statement which outlines ten elements of systems which are essential to ensuring end-of-life care approaches are safe and of a high quality. This Statement is not prescriptive but instead proposes that application of the elements can vary based on local and individual circumstances. Enabling Choice for South Australians will use these elements as focal points to support the capacity building and quality improvement activities within service provider organisations.
Importantly, the Adelaide PHN will also ensure Enabling Choice for South Australians is linked to and supported by other PHN initiatives. Foremost amongst these is the newly launched HealthPathways South Australia. This online portal provides health practitioners with easy access to evidence-based, localised information and referrals for a wide range of health conditions, including palliative care pathways which are due to be released later this year. Another important supporting initiative is My Health Record which is the Australian Government’s secure online summary of a person’s health information, and includes a dedicated space to store Advanced Care Directives.
Enabling Choice for South Australians is an exciting opportunity for Adelaide PHN and providers across the palliative care and broader health sector to build collaboration and capacity around advance care planning and the provision of palliative care in community settings. For more information as the work develops please check the Adelaide PHN website.
Deb Lee, Chief Executive Officer, Adelaide Primary Health Network
Sandra Bradley, RN, PhD, ACD consultant
28/07/2018 12:48 PM
This article does not make any clear what the individual in the community can expect for palliative care. It does not articulate what happens when a person with dementia (a terminal illness), or COPD, or any other end stage illness actually receives in on-the-ground care when they go to their GP. It does not articulate what that GP office will physically provide the person and their carer, for what length of time, for how many episodes of care, and how they will manage the care of the person AND the care of the carer until the patient dies. What the article describes is a continuing of the organisational needs over the individual needs. When I see what you are actually going to give to people in the community (the more than 150,000 in need in South Australia), then I will be able to promote your services better in my capacity as an "on-the-ground" advance care directive consultant. Until then, what you are describing is only of benefit to and for institutions and their institutional servants.
Rapsodie Barbour, Collaborations Officer, Adelaide
7/08/2018 10:11 AM
Thanks for your comments Sandra. We are certainly focused on activities that make a difference to people. We intend that the project supports your role by ensuring everyone who provides palliative care to residents, from family and loved ones to GPs, nurses, carers, pharmacy, hospital and paramedics, knows the decisions the resident has made regarding their end-of-life and palliative care.
Each aged care provider who has indicated interest in being part of this project is putting their hand up to focus on improving the capacity of their staff and systems to identify and prioritise issues which support or get in the way of delivering person centred and directed palliative care.
To keep in touch with the project, keep your eye out for the next issue of the Adelaide PHN Connect magazine, or visit the Adelaide PHN website www.adelaidephn.com.au.