- Which Primary Health Networks (PHNs) have received funding to implement the Measure?
- What activities are being implemented under the Measure?
- Is the Measure being evaluated?
- How will the Measure work?
- Why is this Measure important?
- What are the overarching objectives of the Measure?
- Who will be affected/What is the target population?
- What will guide the implementation of the Measure?
- What is the level of funding for the Measure?
- What is the evidence base for this approach?
- Who can I contact if I have questions?
1. Which Primary Health Networks (PHNs) have received funding to implement the Measure?
The following 11 Primary Health Networks have received funding to implement the pilot Measure:
- Murrumbidgee PHN;
- Gold Coast PHN;
- South Western Sydney PHN;
- North Western Melbourne PHN;
- Eastern Melbourne PHN;
- Central QLD, Wide Bay and Sunshine Coast PHN;
- Brisbane South PHN;
- Adelaide PHN;
- Country WA PHN;
- Western NSW PHN; and
- Primary Health Tasmania.
The PHNs were selected to implement the pilot Measure following a competitive Expression of Interest (EOI) process which was undertaken in August and September 2017.
Funding will support these PHNs to recruit and employ two Full-time Equivalent (FTE) positions to improve coordination and integration of palliative care across primary, secondary, tertiary and community health services to support at home palliative care for those that choose it.
2. What activities are being implemented under the Measure?
The GCfAHPC measure is being trialled in 11 PHNs in six states covering metro, rural/regional and remote areas to improve coordination of care to ensure patients receive the right care in the right place at the right time.
The locally-delivered nature of the GCfAHPC measure allows for the integration of palliative care with other forms of healthcare and community services more broadly. It also enables better engagement with underserved population groups including Indigenous Australians and culturally and linguistically diverse individuals.
For further information on the activities being implemented, refer to:
- PHN GCfAHPC measure – Project Activity Description summary (PDF 497 KB)
- PHN GCfAHPC measure – Project Activity Description summary (Word 117 KB)
3. Is the Measure being evaluated?
Yes, Deloitte Access Economics has been engaged (from July 2018 to June 2020) to undertake an evaluation of the GCfAHPC Measure.
The purpose of this evaluation is to understand what has worked well and any improvements that could be made to the implementation of the Measure.
An Evaluation Plan for the GCfAHPC measure has been developed by the Evaluator to set out the approach that will be undertaken to evaluate the GCfAHPC measure, including all relevant considerations relating to the planning and implementation of the evaluation.
Specifically, the objectives of the evaluation are to:
- Assess the implementation, appropriateness, effectiveness and costs of the GCfAHPC measure;
- Identify the barriers and enablers to achieving intended outcomes;
- Identify any efficiencies and strategies for optimising sustainability and scalability; and
- Identify issues to inform palliative care policy development.
- Evaluation Plan for the Greater Choice for At Home Palliative Care Evaluation (PDF 2115 KB)
- Evaluation Plan for the Greater Choice for At Home Palliative Care Evaluation (Word 498 KB)
4. How the Measure will work?
- PHNs will implement sustainable system changes to strengthen integration and coordination of services for people receiving palliative care at home.
- Working in partnership with other palliative care providers such as community services, specialist palliative care providers and aged care facilities, PHNs will develop integrated models of care that will enable early referrals to palliative care and strengthen community support for their families and carers.
- PHNs will enable greater choice for their local communities through staged approaches to improve sector partnerships, networks, programs, tools and resources in collaboration with specialist palliative care providers.
- Specific models of care coordination will respond to local community needs, be placed based and tailored to suit the requirement/needs of each community.
- Implementation will require co-design of coordinated approaches with the local health/hospital network and the local community to implement home based palliative care.
- Clear governance, communication and accountability frameworks, such as MOUs will also strengthen care-coordination and service linkage.
5. Why is this Measure important?
- The Government has designed this initiative to address a clearly identified need for people requiring palliative care, their families and carers.
- Provided that symptoms can be adequately controlled, up to 90 per cent of people at the end of life prefer to be cared for and to die comfortably at home. Cost-effective care will support patient preferences at the end of life.
- Chronic diseases including cancer and dementia are the leading cause of illness, disability and death in Australia, accounting for 90 per cent of all deaths in 2011, with 5.3 million Australians living with two or more chronic conditions.
6. What are the overarching objectives of the Measure?
The Greater Choice for At Home Palliative Care Measure will:
- improve access to safe, quality palliative care at home and support palliative care systems and services in primary health care and community care;
- enable the right care, at the right time and in the right place to reduce unnecessary hospitalisations;
- generate and use data to ensure continuous improvement of services across sectors; and
- utilise available technologies to provide flexible and responsive care, including care after usual business hours.
7. Who will be affected/What is the target population?
The target population for the Measure is individuals with a known life-limiting condition and their families. Increasingly individuals with chronic conditions – including cancer – are being referred to palliative care alongside their chronic disease management in community settings.
8. What will guide the implementation of the Measure?
Informed by the goals of the National Palliative Care Strategy, the following principles will guide the implementation of the measure:
- Care will be person centred; this includes family and primary care providers and is responsive to cultural and individual needs.
- Activities to be designed with consideration of models of care, where the focus is not just on mapping of clinical pathways, but also on identifying patients that may benefit from early engagement with palliative care and mapping their formal and informal networks and building community capacity to support people at the end-of-life.
- Underpinned by inclusive community approaches, such as Compassionate Communities, to enhance the informal care networks of people requiring palliative care, and identify ways to connect the formal health care services, information and social supports.
- Service redesign and models of care will be based on best available evidence. The measure will be underpinned by data, benchmarking and a continuous quality improvement process to inform the national evaluation.
- Implementation will be underpinned by service and organisational integration.
- Equity of access will ensure that all members of the targeted communities, including people from vulnerable population groups are able to access services.
- Carers have a unique role in supporting someone at the end of life. The importance of their role and need for support before and after death will be acknowledged and respected.
9. What is the level of funding for the Measure?
The Government will provided over $9.0 million across three years (from 2017-18 to 2019-20) to boost funding for PHNs to improve palliative care coordination to support people who have a known life-limiting condition by improving choice and quality of care and support
10. What is the evidence base for this approach?
There are seven key strategies that promote organisational linkages:
- Multidisciplinary team structures
- Written and verbal communication pathways
- Formalised agreements and plans
- Designated linkage worker (funded coordinator role)
- Role clarification
- Knowledge exchange and up skilling
- Continuous improvement (funded monitoring and evaluation role)
11. Who can I contact if I have questions?
If you have any questions in relation to the measure, please send an email to the Department of Health - Palliative Care inbox at Palliative.firstname.lastname@example.org