LIST OF RECOMMENDATIONS
2.39 The committee recommends that the Australian
Commission on Safety and Quality in Healthcare (ACSQH) consider the proposal to
implement a national standard linked to accreditation, noting that reforms
should not result in increased regulatory burden or complexity.
3.80 The committee recommends that the Australian
government considers extracting palliative care from the sub-acute care
category and create a new funding category of 'palliative care'.
3.81 The committee recommends that in determining
the appropriate costing for palliative care services the costs of providing
care in the community sector also be calculated and allocations made to support
the provision of palliative care services by this sector. The committee
acknowledges that any allocations of funds to community sector service
providers would require rigorous and transparent governance arrangements to be
3.82 The committee recommends that the creation of
a new palliative care funding category should result in the establishment of a
palliative care advisory committee by the Independent Hospital Pricing
Authority to advise the Authority on appropriate costing for palliative care
services consistent with the activity-based funding approach.
3.83 The committee recommends that the development
and introduction of consistent national data collection specifically provide
for the recording and reporting of palliative care data.
5.56 The committee recommends that the government,
with the assistance of the Council of Australian Governments, take steps to
improve the provision and timeliness of information to palliative care
patients, their carers and families. Processes should be put in place to ensure
that patients, their carers and families are provided with the right amount of
information, in the right format, at the right time and that a 'show bag'
approach be avoided.
5.57 The committee recommends that this process
begin with a review of the CareSearch website.
5.58 The committee recommends that all governments
work together to fund minimum levels of bereavement service provision for all
families and carers of people with a terminal illness.
5.68 The committee recommends that Government give
careful consideration to the special circumstances of families caring for
terminally ill children when considering future changes to the eligibility
criteria for the Carer Allowance and/or Child Care Rebate.
5.75 The committee recommends that processes be put
in place by the Independent Hospital Pricing Authority to ensure that the
calculation of activity based funding for the provision of palliative care
takes into account its complexities, including the contribution of carers, and
the desirability of its provision across a range of different settings.
6.66 The committee recommends that medical
workforce training include being educated about existing pathways to specialist
palliative care, ensuring that this care is applied effectively to best meet
6.67 The committee recommends that the Australian
government create an ongoing and dedicated national scholarship fund for
postgraduate studies in palliative care nursing.
7.32 The committee recommends that service delivery
models include a greater emphasis on community-based care, 'dying in place',
and a reduction in unnecessary hospital admissions.
8.33 The committee recommends that the Council of
Australian Governments consider developing and implementing a case management
8.34 The committee recommends that the Council of
Australian Governments develop and implement a uniform national palliative care
pathway that clarifies when general palliative care moves into specialist
palliative care, and maps the diagnosis and referral process to ensure that a
palliative patient's journey involves coordinated access to all necessary
8.35 The committee recommends that the Council of
Australian Governments review the Medicare Locals structure to consider how the
provision of palliative care services, both general and specialist, is
integrated into primary health care at the local level.
9.20 The committee recommends that the Commonwealth
government increase its support for paediatric palliative care research.
9.46 The committee recommends that Cancer
Australia, in reviewing the distribution of research funding, discuss with
funding bodies the capacity to ensure that appropriate levels of funding are
being provided to palliative care research.
9.48 The committee recommends that governments
encourage care providers to provide data to the Palliative Care Outcomes
Collaboration and consider making the reporting of this data a condition of
9.50 The committee recommends that the Australian
government develop a nationally funded framework for palliative care research,
as outlined by the Centre for Palliative Care.
9.58 The committee recommends that the NHMRC
publicly report the results of its work on alternative therapy claims in
relation to palliative care.
10.35 The committee recommends that the Council of
Australian Governments examine the viability of introducing a national
equipment library for palliative care patient needs, examining whether such an
approach would allow more efficient and timely provision of available equipment
10.36 To prevent the mis-prescribing of equipment,
the committee recommends that the Australian government investigate current
regulation and consider improving regulation of both private and public
palliative care equipment providers.
10.37 The committee recommends that the Australian
government closely monitor implementation of the recent changes to the Home and
Community Care program to ensure that the program is meeting the needs of those
over 65, and that palliative care recipients who do not fall into the aged care
bracket are receiving adequate support.
10.38 The committee recommends that the Australian
government consider changing the eligibility to Home and Community Care (HACC)
to include palliative care patients or carers of such patients, regardless of
their age. The committee notes that as the HACC program is linked to funding
and funding agreements, the Australian government consider this recommendation
in the context of considering changes to the funding model for palliative care.
10.39 The committee recommends that the Australian
government analyse and identify potential gaps in the provision of palliative
care and palliative care funding for people with disabilities, especially in
11.35 The committee endorses the recommendations of
Palliative Care Australia that, in relation to Commonwealth funded programs, it
training and education about cultural perspectives relating to palliative and
end of life care issues, in core curricula for all health workers and health
practitioners providing services to Indigenous people; and
of palliative and end of life related topics in the core curricula for
Aboriginal health worker Certificate III and IV continuation of PEPA to build
on or develop cultural appropriate education for Indigenous health workers.
11.36 The committee recommends that the Australian
government increase funding to palliative care programs for Indigenous
communities in rural and remote areas, with a particular emphasis on return to
11.42 The committee recommends that the Australian
government give increased attention to the need for improved research,
education and services to support the perinatal and neonatal palliative care
needs of health professionals, pregnant women and their families and newborn
11.66 The committee recommends that, within twelve
months, the Australian government review the implementation and evaluation of
the recommendations of the Paediatric Palliative Care Service Model Review, and
publish the findings of that process.
11.67 The committee recommends that there be
appropriate formal recognition of the Australian and New Zealand Paediatric
Palliative Care Reference Group, and that the Australian government work with
the organisation on the development of a paediatric addendum to the National
Framework for Advance Care Directives 2011.
11.68 The committee recommends that the
Commonwealth, state and territory governments consult with palliative care
organisations, and existing children's palliative care support services Bear
Cottage and Very Special Kids, about the feasibility of, and funding required
for, establishing similar facilities in other jurisdictions.
12.40 The committee recommends that the federal
government initiate a full review of the medications available on the
pharmaceutical benefits scheme for palliative care, particularly schedule 8
12.41 The committee recommends that through the
Council of Australian Governments the federal government expedite the
introduction of uniform regulations for the supply of schedule 8 drugs.
12.42 The committee recommends that the federal
government review the role of nurse practitioners and registered allied health
professionals in prescribing palliative care medications to remove barriers to
accessing such medications in settings of care where these professionals have a
central role in care.
13.60 The committee recommends that in the next
review of aged care accreditations standards, the Australian government
consider requiring some form of advanced care training as a component of the
13.61 The committee recommends the Australian
government increase the level of funding for the Respecting Patient Choices
program, to support development of training providers in several jurisdictions,
significantly expanding the reach of the program in the aged care sector.
13.62 The committee recommends that national model
legislation for advanced care planning be developed, and that all governments
pursue harmonisation of legislation as a high priority.
13.63 The committee recommends that the Australian
government fund a national public awareness campaign around advance care
planning and directives, starting immediately, and expanding once a process of
national harmonisation of advance care planning regulation has been undertaken.
13.71 The committee recommends that
the Australian government ensure that personally controlled electronic health
records have the capacity to include palliative care information, including
advanced care plans.
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