Providers in South Australia are calling for the health and aged care sectors to work better together to improve the delivery of palliative care services in the state.
In a bid to improve access to palliative care services for older South Australians, Aged and Community Services SA & NT and the Palliative Care Council of SA is hosting a forum to help set out a statewide agenda.
Alan Graham, chief executive officer of ACS SA & NT, says he is keen to progress some of the recommendations contained in a review of the SA Government’s palliative care services plan conducted by the state’s Health Performance Council (HPC).
The 2013 report found that a renewed focus was required to partner with the aged care sector to maximise choice for clients, ensure seamless transitions between sectors and make best use of resources.
The HPC said the SA Government had an opportunity to bring together the health and aged care sectors to deliver improvements in palliative care, and that consultations with the aged care sector demonstrated that many providers were “willing and capable” to take on a more active role.
In particular, the report said aged care organisations had an important role to play in the delivery of non-specialist services at the end of life.
Rethinking service delivery
Graham says he supports the HPC’s findings and the government’s current palliative care plan clearly underestimates the role and contribution of the aged care sector.
He wants a health and aged care palliative care plan developed for the state, which takes a broader approach beyond the last days of life and supports clients with a range of terminal illnesses, including those with dementia and non-malignant disease.
“In a South Australian context, the emphasis is very much around the health and hospital model,” Graham tells Australian Ageing Agenda. “If we are going to support more people to die at home, aged care – both in the community and residential care – has a really important role to play going forward.
“The last thing you want is for clients to be tied up in an acute hospital bed or other hospital facility when they could equally be cared for in the comfort of their home or a community setting.”
Graham points to Silver Chain Group’s home hospital model in Western Australia as an example of effective State Government investment in community-based palliative care services and a model that SA should examine closely in its discussions.
A 2011 review of the Silver Chain model by PricewaterhouseCoopers reported high levels of patient satisfaction with timeliness and quality of care, as well as savings to the health system and improved hospital efficiency. Savings per patient were estimated to be between $1,069 and $1,211.
Graham says aged care should be a priority for funding support from SA Health if the government is to meet its objectives of empowering client choice and reducing avoidable emergency department presentations and hospital admissions.
More integrated system
Tracey Watters, CEO of the Palliative Care Council of South Australia, says she hopes the SA forum will advance ideas on how to create a more integrated palliative care system in the state.
She says that although the blurred lines of government responsibility across health, palliative and aged care may present a challenge, there are important precedents set in Western Australia and NSW which demonstrate how successful collaboration can work.
“The forum will be an opportunity to nut out what are the issues and what are the challenges that we need to address in order to make end of life care and palliative care are available to all who need it,” Watters tells AAA.
The forum, which will bring together health professionals, consumers, service providers and government representatives, is expected to take place by early 2015.
Coinciding with discussions in SA, a report released by the Grattan institute in late September also argued for a reallocation of hospital resources to enable more people to die at home.
The authors said the costs of investing in more community-based palliative care services would be offset by reductions in hospital and residential care costs, making the reallocation of funding effectively cost neutral.
To address the lack of funding in home-based palliative care, the Grattan report also recommended that HACC funding be extended to provide community-based palliative care packages that would focus on providing support in the last three months of life.
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