Receipt of specialist palliative care

This section aims to present a more complete picture of specialist palliative care (SPC) service provision in the predictable deaths population by presenting data across multiple settings of care and exploring differences in SPC receipt by sociodemographic characteristics and diagnosis (see Appendix C for more detail). 

Any general practitioner or specialist who cares for patients with life-limiting conditions can adopt a palliative approach to care to provide symptom control and support to patients and their families. However, if a patient requires management of complex problems that are beyond the skills of their usual health care provider(s), referral may be made to specialist palliative care services. This can occur in situations where the patient has intermediate and fluctuating needs that might result in unplanned use of hospital and other services, and/or complex and persistent needs (physical, social, emotional, or spiritual) that are not effectively managed through established protocols (PCA 2018).

Specialist palliative care services are comprised of multidisciplinary teams with specialised skills, competencies, experience, and training to deliver care to people where the palliative needs are complex and persistent. It may involve advice and support on an as-needed basis from existing health care professionals or taking greater responsibility for the management of patients with complex and difficult problems (Palliative Care Therapeutic Guidelines).

While specialist palliative care was developed and mainly used for people with advanced cancer, the benefits of a palliative approach to managing pain and other symptoms for progressive non-malignant conditions is increasingly being recognised. For example, people with progressive organ failure, neurological conditions, and the end-stage of genetic disorders.

The availability of linked data allows, for the first-time, the monitoring of specialist palliative care services across multiple care settings, providing a more complete picture. In this report specialist palliative care is defined as those services provided by palliative medicine physicians/specialists (including inpatient hospital care, outpatient clinics, Medicare-subsidised services; see Health Service Use for further details). It focuses on specialist palliative care services received in the last year of life. Preliminary exploration of the NIHSI datasets indicated that 98% of those who received any specialist palliative care in their last 4 years of life had at least one record of specialist palliative care in their last year of life.

This section focuses on the 52,105 people aged 40+ who received specialist palliative care (SPC) in the last year of life and died from predictable deaths in 2019–20 (referred to as the SPC population). For comparison, information is also presented for the predictable deaths population not receiving specialist palliative care (referred to as non-SPC population) to assess whether the above-mentioned characteristics differ for those receiving or not receiving specialist palliative care.