Table 5.
Attributes of models for palliative care recommended by national policy documents from OECD countries available in English
| Country | Attributes of palliative care service delivery recommended by national policy |
|---|---|
| Australia [23] |
• Provide enhanced, coordinated support for carers, volunteers, communities of carers and carer respite |
| • Provide coordinated, flexible local care delivery for people at the end of life regardless of where they live and address any barriers | |
| • Further improve the skill and confidence of the generalist workforce | |
| • Enhance online palliative care support to ensure adequate numbers of skilled palliative care specialist providers across all disciplines | |
| • Include end of life and palliative care competencies in all care worker training packages | |
| • Enhance and legitimise the role of specialist consultancy services in providing direct clinical advice, education and training, advocacy for end of life issues and training places | |
| • Record and track advance care planning within electronic health records | |
| • Develop sustainable models of quality palliative care in the private sector | |
| • Develop the role of the general practitioner in palliative care | |
| • Undertake further research and ongoing monitoring of the relative cost of care | |
| Canada [79] |
• Availability and access to services |
| • Education for healthcare providers | |
| • Ethical, cultural and spiritual considerations | |
| • Public education and awareness | |
| • Support for family, caregiver and significant others | |
| Ireland [80] |
• Provision of physical, psychological, social and spiritual support, with a mix of skills, delivered through a multi-professional, collaborative team approach |
| • Patients and families are supported and involved in management plans | |
| • Patients are encouraged to express their preference about where they wish to be cared for and where they wish to die | |
| • Carers and families are supported through the illness into bereavement | |
| • The overall whole time equivalent (WTE) SPC nurse to bed ratio should not be less than 1:1 | |
| • In each day care centre, there should be a minimum of one WTE SPC nurse to every 7 daily attendees. | |
| • There should be a minimum of one WTE specialist palliative care nurse per 150 beds in each acute general hospital | |
| • There should be a minimum of one WTE specialist palliative care nurse in the community per 25,000 populations. | |
| • There should be at least one WTE physiotherapist per 10 beds in the specialist palliative care inpatient unit, with a minimum of one physiotherapist in each unit | |
| • There should be a minimum of one WTE community physiotherapist specialising in palliative care per 125,000 population. This post should be based in the specialist palliative care unit | |
| • There should be at least one WTE occupational therapist per 10 beds in the specialist palliative care inpatient unit, with a minimum of one occupational therapist in each unit. | |
| • There should be a minimum of one WTE community occupational therapist specialising in palliative care per 125,000 populations. This post should be based in the specialist palliative care unit | |
| • There should be at least one WTE social worker employed per 10 beds in the specialist palliative care unit, with a minimum of one social worker in each unit | |
| • There should be a minimum of one WTE community social worker specialising in palliative care per 125,000 population. This post should be based in the specialist palliative care unit | |
| • Specialist palliative care services in all other settings, including general hospitals and the community, should be based in or have formal links with the specialist palliative care unit | |
| • All specialist palliative care units should provide day care facilities for patients and carers | |
| • Appropriate transport should be provided for patients to and from the centre | |
| • There should be one point of entry to hospital services for palliative care patients, and subsequent referrals should be speedily organised | |
| • In Accident and Emergency, the patient’s condition should be rapidly assessed, and the patient should be referred to the appropriate team without delay | |
| • The specialist palliative care team in the community should be an inter-disciplinary consultant-led team | |
| • The specialist palliative care team should be based in, and led by, the specialist palliative care unit in the area | |
| • Specialist palliative care nurses should provide a seven-day service to patients in the community | |
| • Arrangements should be made for the transport of patients receiving palliative care to different care settings, when required | |
| • Bereavement support should begin early in the disease process, long before the death of the patient. | |
| • Multidisciplinary assessment to ensure that all needs are identified early and individualised plan is established | |
| • Allocate a care coordinator to each dying person | |
| • Provide access to clinical care for each dying person (medical services, respite care, counselling, etc.) | |
| New Zealand [81] | • Provide access to support services for dying patients and their families |
| • Ensure dying people and their families have access to essential palliative care (initial and specialized palliative acre)- at least one local palliative care service in each district health board | |
| • Provide induction and ongoing training for volunteers in the community assisting in palliative care | |
| • Provide flexible palliative care to meet varying and specific needs | |
| • Inform the public about PCS. |