Call for palliative care overhaul

This week is National Palliative Care Week (24–30 May 2020) — a time for conversations about the benefits of quality palliative care and a celebration of the dedicated workers and volunteers in palliative care across the country.

As part of the week-long event, Palliative Care Australia has released a report calling for an overhaul of the palliative care system in Australia and an additional annual investment of $365 million to bring the system up to speed in a post COVID-19 world.

Report analysis demonstrates that the additional investment will result in a saving of over $450 million across the broader healthcare system every year.

Commissioned with the assistance of the Snow Foundation by Palliative Care Australia and prepared by KPMG, the report found that if people can be supported with palliative care outside of institutional settings, they can live well and die in a place of their choosing; at home, for example. In practice, however, very few Australians are achieving this.

The report calls for a national agreement on palliative care between the Commonwealth and the states and territories, and a new full-time Palliative Care Commissioner, to help create the best experience possible for those with life-limiting conditions and those around them.

Palliative Care Australia Chair Professor Meera Agar said, “All Australians who need palliative care are simply not having access to services when they need to, particularly at home and in community settings.

“As we prepare for an ageing population and other unexpected stresses to our healthcare system, like COVID-19, we must look seriously at reforming our system to ensure it can meet people’s needs into the future.

“Palliative care is about quality of life, living well with a palliative diagnosis and about dying well. Through an additional annual investment of $365 million on national reform, we can save up to $464 million in other health system costs while making the system work best for those experiencing it. We have to spend money to save money and that’s backed by leading economists.”

Palliative Care Australia CEO Rohan Greenland added, “There is a distinct lack of knowledge in what services are available and how to access them. There is limited coordination between the states, territories and the Commonwealth to ensure integrated responsive services which can meet demand and a real need to address inadequacies in specialist numbers.”

KPMG Health Economist and report author Dr Chris Schilling commented, “Our report shows that increasing the provision of palliative care services not only improves health and social outcomes for people experiencing life-limiting conditions, but also helps to lower end-of-life costs to government.

“We analysed specialist palliative care being integrated as a ‘core business’ health approach in three environments: in aged-care facilities, in hospitals and at home.

“Significant savings were made in the first two, while at home the financial outcome was neutral, but in all cases the health outcomes were better. Considerable hospitalisation time — up to 12 days a month — can be prevented by earlier use of palliative care.”

Snow Foundation CEO Georgina Byron said that many Australians with a terminal illness want to die in their home, yet only a small percentage do.

“We must address current service gaps, meet future significant demand and reduce avoidable costs, including preventable hospitalisations and ICU admissions,” she said.

“This can be achieved by investing in quality palliative care and support to carers through organisations like LifeCircle. This report gives credibility for more robust funding systems to ensure access to high-quality palliative care when and where it is needed.”

Government funding falls short

One day prior to the report’s release, Minister for Aged Care and Senior Australians Richard Colbeck announced that the Australian Government will invest $57.2 million to improve palliative care in aged-care facilities across Australia.

This investment is significantly less than the amount stipulated in the report as being needed to make savings across the broader healthcare system.

Under the signed agreements, the Commonwealth has committed funding of more than $3.8 million to South Australia, $925,000 to the ACT, $5.7 million to Western Australia and $396,000 to the Northern Territory.

In-principle agreements are in place for remaining states including Tasmania, Victoria, NSW and Queensland, which have all indicated they will commit funding.

“The states and territories will implement a range of approaches to improve models of care for palliative care in residential aged-care facilities,” Minister Colbeck said.

“This could include the recruitment of palliative care nurse practitioners, the training of aged-care workers in palliative care, and engagement with hospitals to address the palliative care needs of patients in residential aged care.”

Minister Colbeck explained that the funding will help reduce the physical and emotional distress for individuals who require palliative care and their families.

“This investment will assist senior Australians nearing the end of their life in residential aged care to receive quality palliative care,” he said.

“We know how important palliative care is in supporting a person’s physical, emotional, spiritual and social needs.

“This funding will help reinforce the measures in place [to] provide a high level of care during what can be a tremendously difficult time.”

Minister Colbeck said during National Palliative Care Week it was important to focus on how vital the service was for communities and the efforts of the highly professional health workforce who deliver it.

“Research shows palliative care intervention is linked to substantial reductions in the length of hospital stays, fewer hospital admissions and enables people to die in their place of choice.

“Caring for people at the end of life is one of the most important things we can do and this is another step by the Commonwealth to ensure the process is supported.”

To read ‘Investing to Save — The economics of increased investment in palliative care in Australia’, visit https://palliativecare.org.au/kpmg-palliativecare-economic-report.

Image credit: ©stock.adobe.com/au/Photographee.eu