NSW Health’s approach to planning and evaluating palliative care is not effectively coordinated. There is no overall policy framework for palliative and end-of-life care, nor is there comprehensive monitoring and reporting on services and outcomes.
1. Executive Summary
2.1 About palliative care
2.2 About the audit
4. Key findings
4.1 Planning at a state level
4.1.1 Statewide planning and evaluation
4.1.2 Workforce planning and funding service growth
4.2 Planning services at the district level
Planning and evaluation of palliative care services at the district level is the responsibility of Local Health Districts.
This chapter assesses:
- planning and evaluation at a district level
- agreements the districts manage with external service providers.
In the three districts we visited, planning is generally ad hoc with plans in draft form or non-existent and accountability for performance unclear. Only one district we visited has finalised a comprehensive plan. Districts would benefit from:
- better integrating data collection systems with planning
- clearer guidelines, easy-to-use tools, monitoring and accountability systems.
Issues with district planning extend to external agreements with service providers, as these are sometimes poorly managed.
4.2.1 District planning and evaluation
4.2.2 Performance frameworks in external agreements
|Example 1: Performance framework between LHD and an affiliated organisation|
|Palliative care service indicators||Performance measures|
|90% of referrals contacted within 3 business days||Quarterly review and negotiated action|
|Preferred place of death at end of life compared to actual||As above|
|100% of patients assessed regarding their suitability for a specialist palliative care medical review||As above|
|75% of carers satisfied with the service||Annual review and negotiated action|
|1,780 occasions of service per year||Monthly performance monitoring and negotiated action|
|Example 2: Palliative Care Last-Days-of-Life Home Support Services|
|Funding and financial management||
|Education and training||