Have the recent palliative care investments gone far enough for aged care?

National Palliative Care Week acts as a timely reminder that it’s never too soon to start the conversation about matters of life and death, according to the Department of Health and Aged Care’s website

In 2024, Palliative Care Australia (PCA) is promoting the importance of both ‘Matters of Life and Death’ and the ‘people at the heart of quality care’ via the annual campaign. 

So, with the 2024 Budget released just one week before National Palliative Care Week began, we’re taking time to reflect on the key policies and to see whether the Federal Government has truly thrown in its support.

PCA itself responded to the Government’s investments with mixed feelings, expressing pleasure at the continuation of critical programs such as the Comprehensive Palliative Care in Aged Care (CPiAC) measure that received $24.9 million to keep it running for two additional years.

“CPiAC was one of three key priorities PCA and our members highlighted in our 2024 Federal Budget Submission and it is great to see this important program continue,” Camilla Rowland, CEO at PCA, said. 

“It’s an initiative that builds on the recommendations of the Aged Care Royal Commission and was due to finish at the end of this financial year – in just a matter of weeks.” 

CPiAC was introduced to help improve palliative and end-of-life care for aged care residents and it initially received a $57.2 million budget over six years from 2018/19. Both the Federal and all state and territory governments have worked together.

PCA said it has achieved some success by embedding palliative care in the aged care environment, developing models, links and pathways to specialist palliative care services and helping to avoid unnecessary hospital transfers and admissions. 

The Palliative Aged Care Outcomes Program (PACOP) and Program of Experience in the Palliative Approach (PEPA) also received funding from the Government with $10.8 million over two years to extend both. 

PACOP helps residential care providers to systematically improve palliative care outcomes, often by embedding standardised outcomes assessments and tools. PEPA provides free health placements and training specific to palliative care, including specific training for Aboriginal and Torres Strait Islander health workers.

With $35.7 million specifically committed to palliative care support in aged care, it certainly hasn’t been forgotten by the Government. However, PCA feels the opportunity for bolder change was “kicked further down the road”.

“One of our other Budget priorities was addressing the gaps that exist in after-hours palliative care. PCA and our members we will be pressing the Government to do better as part of its current review of after-hours primary care,” Ms Rowland said.

According to their own projections, PCA said $300,000 is all that is needed to analyse gaps in service provision. A refreshed National Palliative Care Implementation Plan could then include nationally agreed benchmarks on access to after-hours specialist palliative care. 

Additionally, Ms Rowland said it was heartbreaking to see the Budget did not support the needs of people under 65 with a life-limiting illness who need basic care and support at home. 

“These are people with a range of terminal illnesses and disabilities who end up in hospital or in emergency departments simply because the day-to-day living supports they need to stay at home are beyond reach,” she said.

“Considering that 70% of Australians say they would prefer to die at home, this is far from the patient-centred approach we all aspire to. 

“Federal, state and territory governments have acknowledged the gap that exists and have agreed something needs to be done. While aged care reforms are vital and necessary for people over 65 years, we are yet to see meaningful reform for people under 65 who can’t access the NDIS, but who still need support at home – it’s become a birthday lottery.”

While the Government may have missed the mark on some palliative care initiatives, PCA has taken the lead in releasing its updated National Standards for Specialist Palliative Care Services. 

This update comes five years after the last review, giving aged and healthcare professionals new benchmarks for quality palliative care delivery. More information can be found on their website.