Major palliative project in aged care aims to provide national framework

Sydney North Primary Health Network (SNPHN) will report to a national PHN meeting in September about its major project now underway with specialist palliative care provider HammondCare to provide quality end-of-life education and training to residential aged care staff.

The Department of Health has invited all 31 PHNs and palliative care organisations to attend a palliative care in general practice workshop in Melbourne later this month to discuss a national study showing PHNs can play a critical role in promoting best practice palliative care in general practice.

If the Sydney North project is successful – following evaluation by Professor Deborah Parker at University of Technology – it could provide a framework for the other 30 PHNs across Australia to “avoid reinvention of the wheel”.

Aged care is one of the six key policy areas for PHNs to address, and Sydney North has extensively researched and analysed the end-of-life needs for its large and growing older population.

“We do palliative care well in cancer services and we need to improve end-of-life in aged care,” SNPHN general manager for primary care advancement and integration Cynthia Stanton told Australian Ageing Agenda.

HammondCare’s project manager, clinical nurse consultant Kelly Arthurs told AAA that more than one-third of the SHPHN’s 135 residential facilities, which vary in size from 30 to 120 beds, had applied for the program.

She said that 20-30 facilities would be chosen to reflect a range of public, private and not-for-profits and a difference in size, resident mix and current staff skills.

“We don’t want to disadvantage services that are currently training staff. We hope to change them from good to brilliant, and improve ones with a lower skills base to provide better services by the end of the project,” Ms Arthurs said.

Frontline staff including registered nurses and care staff will participate in both in situ and off-site training, in a train-the-trainer approach so that it can be delivered and passed onto other colleagues to develop a facility wide community-of-practice approach.

Two palliative care nurse educators are on board and the training will start next month running until June 2018 with the final report due to be concluded in 12 months.

The project will provide a valuable guide to other PHNs seeking to provide or improve their local end-of-life programs in aged care.

Services vary between networks

End-of -life activities vary widely between PHNs.

One Victorian PHN told AAA that its recent board meeting had “an interesting discussion about how residential aged care facilities weren’t usually included in primary care sector consultations and there are some significant issues in that sector with continuity of care, not to mention inadequate funding and poor staffing levels.”

Others in Victoria, such as the North Western Metropolitan and Eastern PHNs have worked closely with the Victorian Palliative Care Regional Consortia and specialist palliative care services in residential aged care.

Elsewhere, Brisbane North PHN has worked since its inception in 2015, and before that as the Medicare local, on palliative care services and training in residential and community care. It also organised an aged care workshop for PHNs and the Department of Health last December.

Palliative Care Australia CEO Liz Callaghan welcomes the increased support of PHNs in end-of-life activities in aged care.

“We view PHNs increased role in palliative care coordination as a positive step, particularly if it supports the building of relationships between primary health care services and specialist palliative care providers, and to assist in identifying where the palliative care system requires additional capacity at the local level,” she said.

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