Most Australians have an expectation that their GP will be able to provide them with the care they need when they are unwell, or at least make sure that they are linked in with the right services. While most GPs feel they have a role to play in caring for patients at the end-of-life, many do not feel confident in doing so.
Recognised barriers to providing palliative care include patient complexity, inadequate training, inadequate access to resources and poor communication from specialists or treating teams.
Palliative care and advance care planning is, and should be, part of the normal scope of practice of all primary care providers. To support this ELDAC has developed the primary care toolkit with relevant information and resources.
Patients with life limiting conditions such as cancer, or chronic diseases like COPD and heart failure, normally have a regular GP. This relationship, commonly built over many years, is one of trust and mutual understanding. GPs have a good knowledge of their patients’ medical history and their preferences for care, as well as their physical, psychological and social capacity to deal with their illness and symptoms. Timely introduction of palliative care for these patients is important and GPs are perfectly placed to do this.
Patients appreciate seeking care in a familiar place with health professionals that they know and trust. Benefits of providing palliative care in the primary care setting include better continuity of care, reduced need for travel and even an improved chance of dying at home.
To do this, providers need skills in managing care needs that can often be complex and challenging, they require linkages to appropriate local resources and services, and importantly, they need the confidence to provide this care in the community. Well delivered palliative care involves management of disease symptoms, psychosocial and spiritual aspects of care, as well as effective coordination of services across the health system.
The ELDAC primary care toolkit was designed by palliative care experts and has been created to help primary care providers and teams through the steps in providing palliative care and supporting advance care planning with patients and their families.
The toolkit is broken down into three sections—Clinical Action, Team Action and HealthPathways.
- Clinical Action - supporting primary healthcare providers in knowledge and practice of advance care planning and palliative care;
- Team Action - supporting primary care practices in delivering best practice care, quality improvement, and in the use of relevant systems e.g. MBS, My Health Record, etc.; and
- HealthPathways - supporting primary healthcare workers in navigating to HealthPathways, mapping of the existing HealthPathways in advance care planning and palliative care across Australia, supporting HealthPathways teams in the development of palliative care and advance care planning HealthPathways, and providing resources appropriate for HealthPathways.
The toolkit leads primary healthcare practitioners and teams through the various steps involved in supporting advance care planning with patients and their families, including considerations for people of various religious and cultural backgrounds. There are links to fact sheets, guides, discussion starters, patient resources and podcasts. Users can also access materials on assessing palliative care needs, providing palliative care, managing dying, and bereavement.
The primary healthcare toolkit is online and freely accessible here.
Katharine Silk, Integration and Innovation Manager, Australian Healthcare and Hospitals Association