The table below describes a framework for accessing palliative
care based on level of need. It articulates and describes the
unique and interwoven roles of primary health care and specialist
care services in collaborative efforts to provide high quality
end of life care.
||Typical resource profile
- Clinical management and care coordination including
assessment, triage, and referral using a palliative approach
for patients with uncomplicated needs associated with a
life limiting illness and/or end of life care.
- Has formal
links with a specialist palliative care provider for purposes
of referral, consultation and access to specialist care as necessary.
- General medical practitioner, nurse practitioner,
registered nurse, generalist community nurse, aboriginal
health worker, allied health staff.
- Specialist health care
providers in other disciplines would be included at this
Specialist palliative care - Level 1
- Provides specialist palliative care for patients,
and families whose needs exceed the capability of primary
- Provides assessment and care consistent with needs and
provides consultative support, information and advice to
primary care providers.
- Has formal links to primary care
providers and level 2 and/or 3 specialist palliative care
providers to meet the needs of patients and family/carers
with complex problems. Has quality and audit program.
- Multi – disciplinary team including medical
practitioner with skills and experience in palliative care,
clinical nurse specialist/consultant, allied health staff,
pastoral care and volunteers.
- A designated staff member
if available coordinates a volunteer service.
Specialist palliative care - Level 2
- As for level 1, able to support higher resource
level due to population
base (eg regional area).
- Provides formal education programs to primary care
and level 1 providers
and the community.
- Has formal links with primary care providers and level
3 specialist palliative care services for patients, caregiver/s
and families with complex needs.
- Interdisciplinary team including medical practitioner
and clinical nurse specialist/consultant with specialist
- Includes designated allied health and pastoral
Specialist palliative care - Level 3
- Provides comprehensive care for the needs of patients,
families with complex needs.
- Provides local support to primary care providers,
regional level 1 and/or 2 services including education
and formation of standards.
- Has comprehensive
research and teaching role.
- Has formal links with local primary care providers
and with specialist palliative care providers level 1 and
2, and relevant academic units
including professorial chairs where available.
- Interdisciplinary team including
a medical director and clinical nurse consultant/nurse practitioner and allied
health staff with specialist qualifications in palliative care.
Generalist and specialist palliative care information
adapted from Strengthening palliative care: a policy for health
care providers 2004-09, DHS, 2004 and Standards for Providing Quality
Palliative Care for all Australians