https://www.youtube.com/watch?v=vux9gXHu_1Q
Palliative care in general practice
GPs are well-placed to provide palliative and end-of-life care for patients.
Palliative care aims to improve the quality of life of patients with life-limiting illnesses. It is often associated with the care of people with cancer, but those with non-cancer end-stage chronic or complex conditions also have significant needs that GPs can help to address.
End-of-life care is an important part of palliative care. It denotes the care and services given to people who are nearing the end of their life, and their families. It often involves bringing together health professionals to help patients to live out their life as comfortably as possible.
Improving palliative care
As our population ages and chronic diseases become more prevalent, improving palliative care has become an Australian Government priority. However, studies have shown many GPs lack confidence in providing this care. Reasons for this include patient complexity, inadequate training and insufficient resources. Poor communication and inadequate links with specialist palliative care services have also been identified as barriers.
An estimated 60 to 70 per cent of Australians would prefer to die at home. GPs and other primary health care providers play an integral role in fulfilling these wishes, where possible. NWMPHN works to support them by:
- improving links between primary care professionals (GPs, practice nurses, residential aged care staff), community and inpatient services palliative care services
- coordinating access to resources for primary health care providers regarding palliative care services in the region
- coordinating access to quality palliative care education for health care professionals in the region.
The Greater Choice for At Home Palliative Care measure provides funding for coordinating palliative care through primary health networks. The first round of funding, in 2018, was used to create a panel of subject matter experts and community members to explore the concept and meanings of the term “dying well”.
This resulted in a report containing several recommendations regarding service gaps in the provision of palliative and end-of-life care in NWMPHN’s catchment. From this we have developed the Precious Time website for support and services in the community.
The current round of funding supports capability building of the primary care workforce, improved integration and coordination between primary care and palliative care providers, and promotion of end of life options to community.
For more information contact education@nwmphn.org.au
We help GPs and primary health care providers to provide palliative care as part of usual practice. We provide education, resources and deliver other activities to support this.
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Palliative care service visits for general practice
Opportunity for general practices to improve the quality of life of patients with life-limiting illnesses.
North Western Melbourne Primary Health Network has partnered with the North and West Metropolitan Region Palliative Care Consortium to offer general practices the opportunity to connect with local community based palliative care providers.
Practices can request a visit from a community palliative care team member to provide information, education, and support, and help improve understanding and access to community palliative care services.
Visits can be virtual or in person as COVID-19 guidelines permit. Visits will be arranged by our liaison officer at a time that suits the practice.
Apply now and help enhance the palliative care journey for patients in our region.
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Education
We run and promote palliative care training and education during the year. Subscribe to our newsletters or visit our events calendar.
You can also find education and training from the organisations below:
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Resources
- End-of-Life Care: Quality Improvement Workbook for General Practice
- Quality improvement activities: Palliative care
- Guide: MBS remuneration to support planned palliative care for patients in general practice and residential aged care
- Precious Time: a consumer website for support and services for end of life care – for people in our region.
- Palliative care videos:
- Understanding the role GPs play in community palliative care (27 September 2023)
- Deferred care session 3: chronic disease management, healthy ageing and palliative care (27 September 2022) (Palliative care commences at 1:07:22)
- Palliative care – How, when and where to refer (3 April 2019)
- For more videos for general practice visit our NWMPHN YouTube channel.
- Palliative care podcasts from other providers:
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HealthPathways Melbourne
For general practice resources, including clinical guidelines, mobile apps, and information on providing palliative care for paediatric patients, patients in residential aged care facilities, and diverse population groups, visit HealthPathways Melbourne.
Core Medicines List and pharmacy locator
To facilitate timely access to palliative care medicines, more than 80 pharmacies in NWMPHN’s region have agreed to stock the localised palliative care Core Medicines List (CML).
The CML was informed by evidence and through consultation with local palliative care providers including GPs, nurses and pharmacists.
Read more about the project on our website.
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Location of pharmacies
The map shows the location of pharmacies that have agreed to stock the CML.
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Core Medicines List for community palliative care patients in the NWMPHN region
Medicine Category First Line Medicines Minimum Quantity to stock Indication/(s) for use in terminal phase patients Anxiolytic Clonazepam 2.5mg/mL (0.1mg/drop) Oral Liquid Midazolam 5mg/mL Injection
(If an injection is required or preferred)
10mL bottle 5 or 10 ampoules
Agitation associated with delirium Anxiety associated with dyspnoea
Antipsychotic Haloperidol 5mg/mL Injection 10 ampoules Agitation Nausea, vomiting
Anticholinergic Hyoscine butylbromide 20mg/mL Injection 5 ampoules Respiratory tract secretions Noisy breathing
Antiemetic Metoclopramide 10mg/2mL Injection 10 ampoules Nausea, vomiting Analgesic (High potency opioid)
Morphine (sulfate or hydrochloride) 10mg/mL and/or 30mg/mL Injection 5 ampoules Dyspnoea Pain
This list does not restrict which medicines can be prescribed for individual patients. Some medicines may not be appropriate in certain circumstances (for example, metoclopramide and haloperidol should be avoided in Parkinson’s Disease). Any questions should be discussed with your local specialist palliative care provider.
Note added 22 November 2023:
NWMPHN is aware of some supply issues with metoclopramide injection, including the discontinuation of PBS-listed Maxolon. Alternative brands of metoclopramide have not yet been listed on the PBS. However, because they are not prohibitively expensive, the recommendation is to continue to prescribe metoclopramide as first line antiemetic medicine. While these supply issues continue, haloperidol injection is also an appropriate alternative therapy for nausea and vomiting in palliative care. However, it is more sedating. This recommendation is based on advice from the Pharmaceutical Society of Australia and local palliative care services. -
Webinar: Anticipatory medicines and medication management for end-of-life care
This recorded webinar equips GPs, community pharmacists and other health professionals with knowledge about anticipatory medicines and medication management for end-of-life care. It provides information and resources regarding the practical and legal aspects of prescribing and supplying medicines for end-of-life care.
The webinar outlines the establishment of a local evidence-based core list to improve timely access to palliative care medicines for patients. The presenters also consider non-pharmacological options and referral pathways to support end-of-life care.
1.5 Educational Activity RACGP CPD hours are available for GPs.
Access the webinar through the Eastern Melbourne Primary Health Network Learning Management System. To access do so, log into your account or please create one here. Once logged in, click on the tile titled Medicines in the last days of life: anticipatory medicines and medication management for end-of-life care.
Palliative Care Services in the NWMPHN region
The North and West Metropolitan Region Palliative Care Consortium supports the delivery of effective, responsive, and accessible palliative care services to people in the north west metropolitan region of Melbourne.
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Community palliative care providers in the NWMPHN region
- Melbourne City Mission Palliative Care covering the local government areas of Darebin, Hume, Merri-bek and Yarra
- Mercy Palliative Care covering the local government areas of Brimbank, Hobsons Bay, Maribyrnong, Melbourne, Melton, Moonee Valley and Wyndham
- Central Highlands Rural Health Palliative Care (Kyneton Health) covering the local government area of Macedon Ranges (part of the Loddon Mallee Regional Palliative Care Consortium)
- Western Health Palliative Care Service covering the local government area of Moorabool (east only – Bacchus Marsh, Ballan) (part of the Grampians Region Palliative Care Consortium)
- Banksia Palliative Care Service covering the local government areas of Banyule, Nillumbik and Whittlesea (outside NWMPHN region but part of the North and West Metropolitan Region Palliative Care Consortium)
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Other specialist palliative care services
Visit the North and West Metropolitan Region Palliative Care Consortium’s Services Quickguide for information and contact details for other specialist palliative care services in the region, including public hospital palliative care units, consultancy services, outpatient clinics, day hospices, and paediatric palliative care.
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Residential in-reach services
