Palliative Care Queensland

Productivity Report: Human Services (end-of-life care in Australia)

This report was sent to Government on 27 October 2017 and publicly released on 26 March 2018.

The Commission has made recommendations on how to apply increased competition, contestability and informed user choice to the human services that were identified in the first stage study report to improve outcomes for users, and the community as a whole.

Key points

  • End-of-life care is provided to people who have a medical condition that means they are likely to die within the next 12 months. Care services include physical, spiritual and psychosocial assessment, and care and treatment delivered by health professionals and ancillary staff.
  • Most of the 160 000 people who die in Australia each year would benefit from end-of-life care but many do not receive care that fully reflects their choices or meets their needs. Demand for care will grow rapidly in coming years as more people enter the older age groups in which most deaths occur.
  • Where it is available, the quality of end-of-life care services in Australia is often excellent. But services are not available everywhere and to everyone who would benefit. Delivery of more effective end-of-life care will require investment and coordinated action across the Australian, State and Territory Governments.
  • Hospitals play an important role in the delivery of end-of-life care. Hospital accreditation standards will, from 2019, prescribe a range of best-practice elements for end-of-life care. This should drive the changes that are needed to improve hospital care. However, dying in hospital is not the preferred outcome for most Australians. Too many people who, with appropriate support, could and would choose to die at home or in their aged care residence, die in hospital. Providing end-of-life care for these people where they live would better meet their clinical needs and reflect their choices.
  • About 60 000 people die in residential aged care facilities each year. End-of-life care should be core business for residential aged care providers but the quality of end-of-life care in residential aged care is patchy at best. Too often, people are transferred back and forth between hospitals and aged care facilities, as aged care facilities lack palliative care expertise and qualified staff to administer pain relief.
  • Many people are unable to communicate their wishes for end-of-life care at the time the care is provided. Yet few people talk about their end-of-life preferences with family and friends, and only about 15 per cent of Australians have prepared for the possibility of being unable to communicate by documenting their end-of-life care preferences in an advance care plan.
  • While Governments have recognised community concern about end-of-life care, progress is being hindered by poor stewardship, including conflict over responsibilities and how service provision is coordinated across different settings. Reforms are needed to put users’ needs and choices at the heart of end-of-life care services, and to ensure those services have the capacity to meet users’ needs.

Download the full report here: 

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