The NSW Auditor-General, Margaret Crawford, has recently released her report on palliative care. The audit assessed whether NSW Health is effectively planning and evaluating palliative care services, in the context of rising demand, increasingly complex needs, and the diversity of service providers.

The main findings reflect that NSW Health’s approach to planning and evaluating palliative care is not effectively coordinated. There is no overall policy framework for palliative and end-of-life care, nor is there comprehensive monitoring and reporting on services and outcomes.

“NSW Health has a limited understanding of the quantity and quality of palliative care services across the state, which reduces its ability to plan for future demand and the workforce needed to deliver it,” said the Auditor-General. “At the district level, planning is sometimes ad hoc and accountability for performance is unclear.”

According to the report, Local Health Districts’ ability to plan, deliver and improve their services is hindered by:

  • multiple disjointed information systems and manual data collection
  • not universally using a program which collects data on patient outcomes for benchmarking and quality improvement.

NSW Health should create an integrated policy framework which clearly defines interfaces between palliative and end-of-life care, articulates priorities and objectives and is supported by a performance and reporting framework. NSW Health should improve the collection and use of outcomes data and improve information systems to support palliative care services and provide comprehensive data for service planning.

The Audit Office states that over the last two years, NSW Health has taken steps to improve its planning and support for Local Health Districts. The NSW Agency for Clinical Innovation has produced an online resource which will assist districts construct their own, localised models of care. And eHealth, which coordinates information communication technology for the state’s healthcare, aims to integrate and improve information systems. These initiatives should help to address many of the issues now inhibiting integrated service delivery, reporting on activity and outcomes, and planning for the future.

Click here to read the full report.