Palliative Care Queensland Impacts of Policy

Palliative Care Queensland is basically an independent not for profit body that represents the palliative care providers, consumers and their families. This organization is concerned with people who have an interest in palliative care in Queensland (The State of Queensland, 2013). This organization works in favor of the people who want to provide ideal quality care at the end of life for all the residents of Queensland. Since this company is a part of the Palliative Care Australia network, it hopes to meet the national aims at the State level.

Palliative care is a very important aspect of the society because a person is meant to go through it at one time or another. In order to get a global perspective on it, it should be noted that over fifty million Americans assist a family member with an illness or a disability on a regular basis. (McMillan et.al, 2006) Palliative care is therefore crucial not only when it comes to the patient but also to his or her family members. It has also been noted that family members of cancer patients go through a lot of stress. Along with the emotional distress, these people go through physical exhaustion, financial worries and loss of time at work (Cancer Council Queensland, 2009)

The policy

Majority of the models of palliative care service delivery in Queensland are based on the idea that most of care at the end of life is going to be provided by the generalist providers, including GPs and community nurses (Sheenan and Schirm, 2003). The reason for this assumption is that nearly all deaths in the community settings and hospitals are uncomplicated and are able to be taken care of by primary health care providers (Palliative Care Australia, 2011).

As a result, in Queensland, local GP and community nursing along with allied health care service are held responsible for providing care at the end of life (Queensland Health, 2010). Nearly all models also contain the ability for generalist clinicians to access specialist support and advice when required for more complex cases. Frequently, this process involves referral to local specialist palliative care team for consultation, in addition may as well include short-term admission for symptom management as well as subsequent referral back to the primary care provider for coordination of future care. Very few Queenslanders at the end of life need a combination of generalist and specialist level care (Naylor, 2011).

At present, there aren't any monitored standards for generalist of non-palliative care specialists who are responsible for providing end of life care (Queensland Health, 2012). Merely a few Queenslanders need referral to a specialist palliative care team for the majority of their care. Specialist palliative care services are provided only to the complex cases which can't be easily managed by generalist level clinicians and primary health care providers. In hospitals, lower level specialist care or generalist palliative care are provided in general medical or surgical units, and sub-specialty units such as; respiratory wards, cancer wards, stroke units, CCU, ICU and cardiac wards (Phillips et. al, 2006). Also, palliative care is provided in RACFs and hospices where this very little or no access to specialist palliative care services.

Currently the funding for palliative care in Queensland is from the Home and Community Care Program. It has been stated that this is the first line of funding that is utilized to support the people who are affected with any terminal illness.

Response of the Government to the Policy and Critique of the Policy

When the recommendations and the main aims of the policy were presented to the government, the government commended the efforts being made by the organization. The government's response to the policy was positive in the sense that it realized the importance of palliative care as a part of a wide spectrum of public health services.

Apart from this, the government also recognizes the other organizations including General Practitioners and non-government organizations who contribute to the department of palliative care. As a part of the response of the Government, it also recognized the need for the public funding of 17 Hospital and Health Services and the reforms that were required pertaining to the governance of the public healthcare system. (Palliative Care Queensland, 2012) The government also recognized the fact that the public sector should be made responsible and accountable for the provision of healthcare services to the local communities (Government Response to Recommendations).

As a response to the Policy, the Queensland Government supports the services of palliative care being provided by the public sector. It also encourages the public sector to take part in the efforts to improve the quality of healthcare services, for which Palliative Care Outcomes Collaboration can be used as a tool (Government Response to Recommendations) The Government will also encourage the private healthcare facilities as well as the other specialist palliative care vendors to take part in and deliver data to PCOC.

The aforementioned reforms have opened up the opportunities for innovative approaches pertaining to the healthcare services. These approaches are flexible, new and have been known to be responsive to the requirements of the local population and the benefits of these reforms and changes have already become evident. However, some of the recommendations in the Report that has been devised to be presented to the government suggest that the control of the public healthcare system should be centralized just how it was in the past. It should be noted here that reverting the system to how it was in the past will confine the responsiveness, innovation and flexibility of the Hospital and Health Services when it comes to the delivery and planning of healthcare services for the local population.

Impact of the Policy

The target group of the Palliative care is the group of people that are terminally ill and their families. It should be noted here that people who are suffering from a terminal illness have unique protocol needs mostly because they do not have much time in which support should be provided to them to resolve their problems and issues (Temel et. al, 2010).

Palliative Care Queensland has offered support to many families all over Queensland by offering them individual protocol support. Support has been provided to many people in Queensland so as to assist them to overcome their problems and issues that are related to making a formal complaint, accessing specialist of palliative care services and funding along with other equipment and community support (Palliative Care Queensland, 2012).

A study was conducted to assess the impact of providing palliative care to the patients, like cancer patients, and to the families of the patients. The results of this study indicated that the intervention in which the patients were giving emotional support and were told and taught how to cope with the symptoms that they develop proved to improve the quality of life of the patients as well as that of their caregivers. However, since the main aim of the study was to evaluate the total quality of life, it was not possible to determine as to which as aspect of life was specifically improved by this intervention. It was also assessed as a part of this study that the burden of caregiver tasks and symptoms of the patients was also seen to improve even if clinical care did not alleviate the symptoms of the patient. On the other hand, this intervention did not prove to be of any benefit with respect to decreasing the feelings of mastery by caregivers. Moreover, the authors also concluded that strongly demanding nature of hospital care might have been a hindrance to make these feelings better. Apart from this, it was also found out that even though the family and caregivers appreciated the emotional support, it did not help alleviate the burden of symptoms or the quality of life of the caregivers (McMillan et. al, 2006).

Recommendations for an Action Plan

As part of the palliative care policy in Queensland, it is required that an action plan be devised in the form of a model of intervention. The action plan, with the help of which palliative care could be provided to the local communities, would include the provision of standard hospital care to the terminally ill patients (Siden, 2002) Apart from this, the patients need to be taught how to cope with the whole situation, and this job has to be done by a burse. The main aim of the action plan is to teach the patients how to assess, analyze and then manage their symptoms. This action plan was primarily developed for cancer patients who are being taken care of at home and their families. The action plan is based on four components. The first component of this action plan is creativity, the second being the assessment of the problem with a different perspective. Optimism, a realistic but positive attitude, planning, setting of reasonable goals and taking necessary measures to reach them and specialist information were also included as important components of this action plan (Siden, 2002). The aforementioned components should be there as part of any action plan that is devised to provide palliative care as part of the policy.

It should be noted here that in order for PCQ to provide healthcare services to the local population all over Queensland, there are certain recommendations that need to be made a part of the policy. It is recommended that the Minister for Health provides resources at the earliest for 24-hour palliative care information that would be available over the telephone and all over the state along with support and referral service (Palliative Care Queensland, 2012). Apart from this, skilled nurses along with other allied health and all the required support should also be made available over the internet. Special alterations need to be made in the policy with respect to the palliative care that needs to be provided to the small children and adolescents with a life limiting condition. Apart from this, there is a need for special recommendations for the accommodation of Aboriginal people, since they have been subjected to discrimination since the beginning of times.

Legal and Ethical Issues

The legal issue that PCQ policy is faced with is that at every level, there would be a need for intervention at the government level. For example, when it comes to make sure that no citizen of the society is denied access to palliative care, it is the duty of the Government and Health Ministry to make sure that justice is being done. Apart from this, funding is also a legal issue that needs to be addressed by the government. As for the ethical issues, the issue of Aboriginal people needs to be addressed. It should be noted here that the government needs to make sure that accommodation is being provided to the Aboriginal people who are terminally ill and their families when they have come a long from their place of residence seeking palliative care.

Conclusion

Being an independent and non-profit organization, Palliative Care Queensland's mission is to make sure that every dying person in the State is provided with quality healthcare at the earliest (Australian Institute of Health & Welfare, 2007). The main aim of this organization is to create awareness of palliative care in the local community and to take appropriate steps to ensure the provision of palliative care to the terminally ill patients, irrespective of their age and ethnicity. As part of the policy of palliative care devised by PCQ, nursing and healthcare staff is being educated about palliative care and its application (Palliative Care Australia Position Statement, 2010) (Palliative Care Queensland, 2012).