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Rural palliative care patients disadvantaged by poor access to primary health

Author: Anna Manzoney
20 August 2015
  • Decision Assist Linkages Grants are designed to help build better links between Australian palliative and aged care providers

A recent survey by New South Wales aged care provider the not-for-profit Whiddon Group has found access to primary health providers, including specialist palliative care, is a significant barrier for its rural and remote clients.

The Whiddon Group is one of the recipients of a Decision Assist Linkages grant, aimed at building better links between the providers of palliative and aged care across Australia.

The grant enabled the project team to undertake a survey of each Whiddon site in metropolitan, regional, rural and remote communities.  This was to better understand existing linkages with specialist palliative care service providers, access to primary health providers, and the individual strengths of each facility providing care for clients with palliative needs.

The survey found that while most of Whiddon’s NSW sites had access to specialist palliative care teams as part of their Local Health District, one rural community was able to access specialist palliative care only through a private provider in a neighbouring town. The remotest sites, Bourke and Walgett, were over 400 kilometres from the nearest specialist palliative care provider and had access to a Registered Nurse only one day a week and a fly in, fly out, locum GP at the local medical practice.

The survey identified access to primary health providers, particularly after hours, as a barrier to many sites in providing care for clients with palliative needs. Survey respondents said that in their experience the main reasons a client would be transferred to hospital for end of life care were as a result of a family request, pain management and unclear Advance Care Directives.

As a result of the survey, the project team is now working with each site to promote the use of available palliative care resources, including Decision Assist, PEPA, Care Search and PalliAged. The team is developing communication pathways and tools that reflect the individual needs of clients, staff and available resources within each community.

According to the Whiddon Group, using these tools will enhance the care of clients with palliative care needs, improve the quality of advance care and end-of-life conversations and documentation, and reduce hospital admissions for end of life care.

The new communication pathways and tools will be rolled out in 19 residential aged care services across the state, stretching from Bourke and Narrabri to Tweed Heads. 

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