There is national and international recognition of the need to integrate end-of-life care into existing health services and engaging the broader community in supporting those in need of care.
Inequitable access to end-of-life care is evident for some populations and is generally based on ethnic and cultural variables. In Australia, inequitable access is prominent in rural and remote communities, Aboriginal and Torres Strait Islander populations, as well as non-cancer patients and older people living in residential aged care facilities.
Furthermore, identifying deterioration and diagnosing when a patient is/may be moving into the end phase of their life is recognised as complex and challenging for many clinicians. Barriers that contribute to delays in initiating end-of-life care include:
- a disconnect between the aims of modern medicine to cure and the acceptance of death as a likely outcome
- a cultural/societal fear of initiating conversations and discussing death (by both health professionals and the general public)
- impact of health financing mechanisms that do not fund service models such as ‘consultation–liaison’ and ‘shared care’ practices.
To address these issues, Queensland Health developed the Statewide strategy for end-of-life care 2015, with the Care at End of Life Project Team responsible for overall implementation of the Strategy throughout Queensland, in collaboration with key stakeholders.