Welcome to the quarterly Advance Care Planning and End of Life Newsletter, which is jointly published by the Agency for Clinical Innovation (ACI), Clinical Excellence Commission (CEC) and the NSW Ministry of Health.
The newsletter provides updates on ACI, CEC and Ministry Advance Care Planning and End of Life projects and a guest spot for a local health district, specialty network or pillar to provide information on their Advance Care Planning and End of Life Care initiatives. Districts, networks or pillars wishing to provide an update in Issue 2 should email:
In this edition
- Guest update: NSW Ambulance
- Agency for Clinical Innovation's update
- Clinical Excellence Commission's project update
- NSW Ministry of Health's update
Guest update: NSW Ambulance
Ensuring that patient’s wishes are respected and that they receive safe, quality, timely and appropriate care is an important responsibility of all healthcare providers, including NSW Ambulance paramedics.
Paramedics seek to support patients with palliative or life limiting conditions by providing care in the preferred location, maintaining patient dignity, maximising comfort through appropriate analgesia and controlling symptoms such as nausea and enhancing quality of life. Paramedics also seek to support patients and families by helping to alleviate fear and anxiety associated with dying and death.
The care provided by NSW Ambulance paramedics aligns well with four of the essentials of palliative care:
- access to care providers across all settings who are skilled in caring for people approaching end of life
- care is based on the assessed needs of the patient, carer and family
- seamless transitions across all care settings
- quality care during the last days of life.
A number of processes and procedures are in place to support NSW Ambulance paramedics when they respond to patients with palliative needs or a life limiting illness or at end of life:
- NSW Ambulance Authorised Palliative Care Plans enable a person’s prior wishes to be known should they lose decision making capacity as end of life approaches. The purpose of the NSW Ambulance Authorised Palliative Care Plans is to complement services already in place; and provide a safety net for the palliative patient seeking unplanned access to healthcare through calling Triple Zero (000). The Authorised Palliative Care Plan also supports the paramedic in their clinical decision making and in meeting the needs of individual patients as well as respect the care wishes of palliative patients. This is achieved through endorsing the paramedic to deliver safe, quality and appropriate care outside their normal scope of practice.
- NSW Health Resuscitation Plans are incorporated into NSW Ambulance protocols to support paramedic clinical decision making and provide direction in cardiac arrest situations when patients are being transferred or referred between facilities.
- PD2015_040 Death – Verification of Death and Medical Certificate of Cause of Death, Verification of Death along with relevant NSW Ambulance protocols supports NSW Ambulance paramedics to verify death. Paramedics are currently undergoing training on assessment and documentation of death.
For more information on NSW Ambulance procedures and end of life matters:
Michelle Shiel, Manager, Low Acuity Care
Email: email@example.com or firstname.lastname@example.org.
Agency for Clinical Innovation's update
The Palliative & End of Life Care Blueprint was launched in 2015. Visitors to the site can watch videos and access tools and resources for each of the Blueprint's ten Essential Components of Care.
Planning tools and resources will progressively reflect the activities and approaches requested by LHDs and other services.
The first Palliative Care Network statewide forum to learn from LHDs and other services about their local priorities for improvement was held on 2 March.
For more information contact:
Rob Wilkins, ACI Palliative Care Network Manager
Phone: (02) 9464 4666
Clinical Excellence Commission's project update
The CEC’s End of Life program aims to provide clinicians with the support and tools to ensure safe, quality end of life care for patients in NSW public health organisations.
The admitted patient death screening tool standardises screening of all in-patient deaths and includes indicators on the quality of dying. Specific measures at the end of life provide an opportunity for ongoing monitoring and evaluation of the delivery of this care. Over 85% of facilities are using the tool and database with over 20,000 deaths screened.
Working with clinicians and consumers, tools dealing with end of life care have been developed for generalist medical and nursing staff. The tools were developed through review of current literature alongside best practice. Consultation is underway until 27 March.
A framework to encourage clinicians, patients and families to continue with treatment, if they wish, in the hope of a recovery, whilst talking openly about preferences and plans for end of life. This program is available for facilities where end of life management could be improved.
For more information contact CEC End of Life Program:
Phone: (02) 9269 5596
NSW Ministry of Health's update
Draft NSW Health Advance Care Directive Template
The Ministry is conducting consultation on the draft template until the end of April.
Dignity, Respect and Choice: Advance Care Planning for End of Life for People with Mental Illness
The resource includes an introductory guide for people with mental illness, their families and carers, available in 11 languages and a comprehensive guide for health professionals. It won the 2015 Marion Seal Award for best project at the Advance Care Planning and End of Life Care National Conference.
SHAPE End of Life Conversations
The Supporting Health professionals in Advance care Planning and End of life (SHAPE) Conversations education framework provides a guide for conducting effective end of life conversations with patients, families and carers. It includes a HETI eLearning module for NSW Health staff and an interactive workshop, which has been designed to be facilitated by Districts/Networks using a package developed by HETI.
Non-NSW Health staff in aged, community and primary care may access the module on GEM free of charge. They need to create an account to access the module.
The policy was released in September 2015. It outlines the process for assessment and documentation to verify death and for medical certification of death. Two HETI modules are available to NSW Health staff to support implementation:
- Verification of Death
- Managing Death and Death Certification.
For more information contact the Office of the Chief Health Officer
Palliative Care After Hours Helpline
The Palliative Care After Hours Helpline started in NSW on 1 March 2016. It will provide professional health information, support and advice to palliative patients, carers, parents/carers of paediatric patients, families and health professionals. The Helpline is intended to complement existing palliative care services provided during the day and give people more choice about the care they can receive at home by providing advice and support at night, on weekends and public holidays. It will be operated by registered nurses with training in palliative care. Specialist palliative care nurses with expert knowledge, skills and recent experience in palliative care will provide advice and support for patients with more complex issues.
For more information contact Integrated Care Branch