6. Policy context
Policy context
International and national context
International and national palliative care strategies outline the importance of health systems providing high quality and accessible palliative care. This Strategy aligns with other strategies and describes Queensland’s approach to strengthening palliative and end-of-life care services.
In 2013, the World Health Assembly adopted a resolution to include palliative care in all health systems, at all levels of care, and for the whole population.
In January 2014, the Executive Board of the World Health Organization published policy directions recognising the need for palliative care and end-of-life care to be provided ‘in accordance with the principles of universal health coverage’ and for palliative care to be offered by all health systems. These policy directions were endorsed by the World Health Assembly in April 2014.
The Australian Government, in partnership with states and territories, leads policy development for palliative care in Australia. The national policy direction for palliative care is set through the National Palliative Care Strategy 2018 and supporting Implementation Plan. Queensland has committed to support the implementation of the National Strategy and ensure the highest possible level of palliative care is available to all people in Queensland. This commitment will be met by implementing the actions in our Strategy.
The Australian Government also has a key role in supporting palliative care in the community through primary care. We will continue to advocate to the Australian Government for increased investment, particularly across primary care and in community settings, to support the delivery of palliative care services in Queensland.
Palliative Care Australia is the Australian peak body for palliative care. The Palliative Care Australia Roadmap 2022–2027 sets the direction Australia needs to take from now until 2027 to ensure high-quality palliative care is available for all who need it, where and when they need it. It outlines key areas to be prioritised across investment, support for carers, workforce, awareness campaigns about death, dying and palliative care, data and research, and palliative care in aged care. This Strategy aligns to these key areas.
State context
While the focus of this strategy is palliative care and end-of-life care services, lessons from across the health system have been incorporated to improve access and equity of access to services. The report Unleashing the potential: an open and equitable health system - Healthcare for Queenslanders in a pandemic ready world explored lessons from the COVID-19 pandemic. It offers recommendations to progress reform across the continuum of care and create a health system:
* that is focused on consumers,
* that is integrated across health providers,
* that supports a flexible and empowered workforce,
* where clinicians, consumers and providers genuinely work in partnership, and
* where good ideas and practices are evaluated and shared across the system.
The new Strategy also builds on directions and actions from Queensland's previous Statewide strategy for end-of-life care 2015. Both strategies aim to strengthen the capacity of Queensland Health servicesto respond to the needs of peoplewith a life-limiting illnessand deliver high-qualitypalliative care services.
A key component of delivering quality services is making sure that the rights and interests of people with a life-limiting illness are protected and recognising the needs of people who may be vulnerable or at risk, including but not limited to, Aboriginal and Torres Strait Islander peoples, people with disability, people from culturally and linguistically diverse backgrounds, people with cognitive impairment, people experiencing homelessness and older people. All people have the right to exercise choice to access palliative care services based on their preferences, and in the environment of their choosing. Appropriate advanced care planning supports people to make and/or communicate decisions about their own life and the type of care and outcomes they would consider acceptable, and helps to ensure that their preferences are documented and respected.
Guidance and resource materials should be available to health professionals and others who care for people with life-limiting illnesses. Through information and education, professionals should have enhanced capacity to support decision-making practices, identify potential forms of abuse such as elder abuse, and to address issues.
This Strategy reflects these needs. It includes actions that strengthen person-centred palliative care services through greater collaboration, integration and use of technology. The Strategy also contains actions that will help to develop a skilled workforce, through the provision of targeted information and professional development opportunities, to ensure staff are able to respond to the diverse needs of people with a life-limiting illness.
Health equity for First Nations peoples
End of life is a significant and sensitive time for First Nations peoples. It is a time that is subject to important customary and cultural practices and has meanings that are sacred to First Nations peoples.
This Strategy supports Queensland Health’s First Nations health equity reform agenda. Recent amendments to the Hospital and Health Boards Act 2011 and Hospital and Health Boards Regulation 2012 have created the strongest legislative foundation for Queensland's public health system to achieve health equity for First Nations peoples and eliminate institutional racism across Hospital and Health Services. These legislative amendments and the release of the Making Tracks Together – Queensland’s Aboriginal and Torres Strait Islander Health Equity Framework are placing First Nations peoples at the centre of healthcare design and delivery, including palliative care and end-of-life care services.
The Strategy prioritises investment in First Nations led culturally appropriate and family-centred models. It recognises the kinship ties among First Nations peoples and communities to deliver holistic palliative care. This is supported by the Queensland Health Specialist Palliative Care Workforce Plan which builds the capability of palliative care services by growing the First Nations palliative care workforce across the system.