Palliative Care services to take a leap forward
From: Jill Stringer
Date: 3 December 2007
Subject: DHB developing better integrated Palliative Care services
Wairarapa’s Palliative Care services are poised to take a leap forward.
Current services are well respected in the Wairarapa, and greatly appreciated by people who use them – but a review in 2005 showed that they were not well integrated, and access to the services is inconsistent. “There are opportunities for improvement,” says Lisa Burch, of the DHB’s Planning and Funding unit. Following the review a new plan for palliative care services has been completed. The plan sets out a new framework for service delivery.
Palliative care is the care of people of all ages with a life limiting illness, with little or no prospect of a cure, and for whom death is the likely outcome – be that hours, days, weeks, months or sometimes years away. Specialist palliative care is currently provided by Te Omanga Hospice for approximately 75 people each year, and district nurses provide general palliative care services for approximately 150 people each year.
“We’re now at the point where we can launch the new ‘Palliative Care framework’ for the Wairarapa,” says Lisa. “There has been a great willingness to ‘look outside the square’ by the people involved in palliative care to see how we could provide a high quality service equitably for all Wairarapa residents.”
The new framework provides for a structured and coordinated approach with providers taking on different roles. The majority of individual patient care will be carried out by generalist palliative care providers such as district nurses, primary care nurses and GPs, and Maori providers. It will mean a reduction in hands on patient care for our specialist provider Te Omanga Hospice.
“The specialist provider will oversee the framework and palliative care carried out by other providers,” says Lisa. “They will also provide education, training and specialist advice to general providers.”
The way in which people access services has also been clarified in the new plan. People will be referred to palliative care through FOCUS, where a Palliative care Coordinator will assess their level of need for services and coordinate the services they need.
“People needing palliative care may have multiple needs,” says Lisa. “They may need some assistance at home as well as palliative care, some regular medication from their GP, or a brief stay away from home to provide some respite for family and care givers. FOCUS will ensure that they are directed to the right services.”
When someone is referred to FOCUS for palliative care, a care plan will be written with input from the clients and all the health services involved. This could include the GP, specialist palliative care provider, home support and family/whanau. A lead palliative carer will be identified who will make sure that patients get access to the right services and that the right information flows between services.
“The DHB is currently working through a competitive purchasing process with specialist palliative care providers,” says Lisa. “Once this has been finalised, the next step is to find out which providers want to provide general palliative care and put some training and support in place for them. In the meantime, FOCUS is developing their role in coordinating access to palliative care services.”
The Palliative Care Plan 2007 is freely available on the DHB website: www.wairarapa.dhb.org.nz .