End-of-Life and Palliative Care recommendation response summary
Recommendations 7 to 18 relate to End-of-Life and Palliative and cover a number of matters including:
- Palliative care service provision across WA
- Palliative care service models and funding
- End-of-Life and palliative care policy and governance
- End-of-Life and palliative care education for health professionals and the community.
The WA Government supports the aforementioned recommendations, noting dependencies. Many of the recommendations build on preceding and current work being undertaken by the Department of Health described in the WA End-of-Life and Palliative Care Strategy 2018-2028 and The End-of-Life Framework.
The WA Cancer and Palliative Care Network Policy Unit is undertaking further consultation and planning on the implementation of recommendations 7 to 18.
Recommendation 7
The Minister for Health should facilitate the establishment of an inpatient specialist palliative care hospice providing publicly funded beds in the northern suburbs of Perth.
Recommendation 8
The Minister for Health should ensure that community palliative care providers, such as Silver Chain, are adequately funded to provide for growing demand.
Recommendation 9
WA Health should conduct an independent review, from a patient’s perspective, of the three models of palliative care in Western Australia; inpatient, consultative and community. The review should examine the benefits and risks of each model and the accessibility of each across the state as well as the admission criteria for hospice care.
Recommendation 10
WA Health should implement a process to determine the unmet demand for palliative care and establish an ongoing process to measure the delivery of palliative care services with the aim of making those services available to more Western Australians.
Recommendation 11
To improve understanding of palliative care in Western Australia, WA Health should:
- Establish a consistent definition of palliative care to be adopted by all health professionals;
- Provide comprehensive, accessible and practical information and education services about palliative care to health professionals and the community;
- Encourage knowledge sharing by palliative care specialists with their generalist colleagues; and
- Establish a palliative care information and community hotline.
Recommendation 12
The Minister for Health should prioritise policy development and improved governance structures for the delivery of palliative care by WA Country Health Services.
Recommendation 13
The Minister for Health should ensure regional palliative care be adequately funded to meet demand.
Recommendation 14
Once a consistent definition of palliative care has been established by WA Health in accordance with Recommendation 11, the Minister for Health should appoint an independent reviewer to audit:
- The level of palliative care activity actually provided in Western Australia’s hospitals and compare it against the level of recorded palliative care activity.
- The actual spend by WA Health on palliative care on a year-by-year and like-for-like basis, across all aspects of palliative care provision, including community service providers, area health services (including WA Country Health Services) and delineating between inpatient, consultancy and community care.
Recommendation 15
WA Health should provide ongoing professional development for all health professionals – beyond undergraduate training – about the right of a patient to refuse medical treatment.
WA Health should also specifically amend the Consent to Treatment Policy to provide comprehensive information in relation to a competent patient’s absolute right to refuse medical treatment.
Recommendation 16
WA Health should provide ongoing professional development – beyond undergraduate training – for all health professionals regarding the absolute right of a competent patient to refuse food and water. Training should also include those working in aged care.
Recommendation 17
WA Health should provide ongoing professional development – beyond undergraduate training – for health professionals about the transition from curative to non-curative end of life care and effective discussions with patients and families about futile treatments.
WA Health should consider how it might effectively educate the community about end of life decision-making, and implement appropriate health promotion in this area.
Recommendation 18
WA Health should provide specific guidelines on the use of terminal sedation by health professionals for patients at the end of life. These guidelines should include an agreed name and definition of the treatment.
As per any other medical treatment, the requirement for informed consent must be clear.
The treatment must be specifically noted in the medical record as 'terminal sedation.'