General Practitioners (GP) are central to Primary Health Care 

General Practitioners (GP’s) provide a smooth transition from chronic disease management to treatment of advanced illness, to a palliative approach, end-of-life care, and terminal phase. GPs are proactive in establishing palliative care for individual patients who remain in their home or a residential aged care facility by establishing a care pathway, coordinating care across the health system, and by collaborating with other healthcare providers.


The increasing need for palliative care in primary health care

The number of people with conditions that might benefit is considerable and this is increasing. For example, among adult Australians in 2017-18 those with or at high risk for life-limiting chronic conditions included:

Estimated 472,000 people living with dementia. [1]

1.2 million people (4.8%) with heart, stroke, and vascular disease. [2]

598,800 people (25% with chronic obstructive pulmonary disease (COPD). [2]

432,400 people (1.8%) cancer. [2]

237,800 people (1.0%) kidney disease. [2]

Just under half (47.3%) of Australians had one or more chronic conditions. [2]

Prevalence for these conditions is highest among people over 65 years of age. In 2016, 15% of Australia’s population were in this age group, and 30% of GP encounters were with people in this age group. [3]

Many of these people will require symptom management and support for emotional, psychological, social, and spiritual needs.

What palliative care within primary health care looks like

There are three levels to palliative care. Primary care providers care for many people coming to the end of their life. The involvement of Primary Health Care depends on individual needs.

  • If a person’s needs are straight forward and predictable - GP and other health professionals will give care and advice.
  • If a person’s needs are sometimes, but not always, more complex – health professionals will provide care with advice from palliative care specialists.
  • If a person has complex needs – palliative care specialists will provide care and advice through partnership with existing health care providers. [4]

A multidisciplinary approach is optimal for palliative care delivery in the primary health care setting where each health professional can contribute to improving the quality of life of palliative care patients. Knowing their scope of practice and how they can be incorporated into a patients palliative care is important.

Getting Started

Some suggested ways you can get started with palliative care include:

Education:

You can upskill with free evidence-based practical learning modules from the Advance Project. These learning modules are specifically designed to support GPs, practice nurses and practice managers to initiate advance care planning conversations and assess patients and carers palliative and supportive care needs.

Screening tools:

To identify current people with deteriorating health due to advanced conditions or a serious illness that will require palliative care you can use tools such as the Surprise Question and SPICT tool.

Planning:

Learn more about advance care directives and advance care planning and why they are important.

Awareness of local needs:

Understanding the need for palliative care in your community can help to promote access to services. To assess the broader need for palliative care within your local community the needs assessment reports from Primary Healthcare Networks (PHNs) can be useful.

  1. Dementia Australia (2018) Dementia Prevalence Data 2018-2058, Commissioned research undertaken by NATSEM, University of Canberra.
  2. ABS National Health Survey: First Results, 2017-18 (cat. no. 4364.0.55.001)
  3. Britt H, Miller GC, Bayram C, Henderson J, Valenti L, Harrison C, Pan Y, Charles J, Pollack AJ, Chambers T, Gordon J, Wong C. A Decade of Australian General Practice Activity 2006-07 to 2015-16.  General Practice Series No. 41. Sydney: Sydney University Press. 2016
  4. Palliative Care Australia. Palliative Care Service Development Guidelines, page 10.  Palliative Care Australia. January 2018

Last updated 16 September 2021