3. Introduction
Introduction
Background and context
The Queensland Government has committed $171 million in additional funding for palliative care services, including dedicated funding of $102.5 million to develop a workforce plan and increase our specialist palliative care workforce by 2025-26.
Informed by the findings and recommendations from the Queensland Parliamentary Inquiry into aged care, end-of-life in palliative care and voluntary assisted dying, a new Queensland Palliative and End-of-Life Care Strategy will set the strategic directions and guide investment decisions over the next five year implementation period. The strategy builds on previous reforms in Queensland and is the next step in the journey to strengthening the palliative care system. Under the Strategy, investment will be targeted at key activities to support a person's palliative and end-of-life care journey and better meet the needs, preferences and goals of the individual and their family at the end of life. The Strategy aligns to the National Palliative Care Strategy 2018 and its associated implementation plan.
The Voluntary Assisted Dying Act 2021 was passed in September 2021 and will be available to eligible Queenslanders from the 1st of January 2023. Voluntary assisted dying is an additional end-of-life choice that gives eligible people who are suffering and dying the option of asking for medical assistance to end their lives. The Queensland Government's implementation and provision of voluntary assisted dying services is separate to the investment for additional Queensland Health specialist palliative care workforce.
The Queensland Health Specialist Palliative Care Workforce Plan is a key component of the Queensland Government's investment to build and develop the Queensland Health specialist palliative care workforce as a key enabler in the delivery of specialist palliative care services. The Workforce Plan is a complementary document to the Strategy.
Currently, health consumers and their families in Queensland may experience differing and inequitable access to specialist palliative care services as a result of where they live. Addressing this inequity is one of the key priorities of the Strategy and Workforce Plan.
This Workforce Plan aims to position the specialist palliative care workforce within Queensland Health to provide equitable, responsive, culturally safe and appropriate and holistic treatment and care to people with life-limiting illnesses of all ages and provide support for their families and carers in Queensland. The Workforce Plan focuses on strategies and actions to build, attract, recruit, develop and retain a specialist palliative care workforce.
What is specialist palliative care and who delivers this service?
The National Palliative Care Strategy 2018 defines specialist palliative care as: “Services provided by clinicians who have advanced training in palliative care. The role of specialist palliative care services includes providing direct care to patients with complex palliative care needs, and providing consultation services to support, advise and educate non-specialist clinicians who are providing palliative care.”
In Queensland, generalist palliative care is provided across a range of settings by a wide network of general practitioners (GPs), Aboriginal and Torres Strait Islander Community Controlled Health Services, other medical specialists such as paediatricians, oncologists and geriatricians, nurse practitioners, nurses, allied health professionals, counsellors, pastoral carers, family members and others.
Queensland Health also delivers specialist palliative care services. The current Queensland Health specialist palliative care workforce primarily comprises but is not limited to specialist palliative medicine physicians, nurse practitioners, clinical nurse consultants and clinical nurses a range of allied health professionals (including social workers, occupational therapists, bereavement counsellors, psychologists and pharmacists), and supporting administrative and other staff. The workforce within any one specialist palliative care service depends on the model of care, health service setting and geographical location. This workforce is currently primarily located in the south-east corner of the State and in larger cities in regional Queensland.
Very few First Nations healthcare workers currently work in either generalist or specialist palliative care.
The Queensland Health specialist palliative care workforce
In September 2021, based on validated workforce profiles developed from payroll data and consultation with individual Hospital and Health Services, it was reported that 265.61 permanent full-time equivalent (FTE) health professionals and supporting staff were dedicated to delivering specialist palliative care in Queensland Health. An FTE refers to full-time equivalent employees currently working in a position, and several part-time employees may add up to one FTE.
The total workforce included 66.30 FTE dedicated specialist palliative care medical practitioners and 140.03 FTE specialist palliative care nurses.
In addition, there were 33.14 FTE dedicated specialist palliative care allied health practitioners including social workers, psychologists, occupational therapists, pharmacists and bereavement counsellors. It is noted that allied health services for Queensland Health specialist palliative care services are often accessed through the generalist allied health service or related services such as oncology, offered within the relevant facility.
The dedicated specialist palliative care Aboriginal and Torres Strait Islander workforce was 1.00 FTE and the dedicated specialist palliative care administration workforce supporting the clinical workforce above was 25.14 FTE.
Please refer to this information as depicted on this pie chart. Queensland Health Specialist Palliative Care Workforce - Full-time equivalent (FTE) per profession as at September 2021. This profile does not include staff employed on a temporary basis at that time, such as in the Specialist Palliative Care in Aged Care (SPACE) Program.
It is noted that, in November 2021, the Department of Health approved recurrent funding to continue the statewide Specialist Palliative Rural Telehealth Service (SPaRTa), delivered by Gold Coast, Sunshine Coast, Townsville and Cairns and Hinterland Hospital and Health Services. Recurrent funding was also approved to continue the Paediatric Palliative Care Outreach Collaborative (PPCOC), delivered by Children's Health Queensland. Both services were previously funded non-recurrently through the Care in the Right Setting (CaRS) Program. This funding further expanded the permanent Queensland Health specialist palliative care workforce by 6.9 medical practitioner FTE, 4.5 nursing FTE, 9.0 allied health FTE, and 5.6 administration FTE in advance of additional investment under the Workforce Plan.