Dying people in Victoria are facing waiting lists of up to six weeks for specialist care to relieve their pain and suffering and many who want to die at home are not able to because palliative care services are overwhelmed, an audit has revealed.
An Auditor-General investigation found that in 2012–13, 67 per cent of people who died in the care of a Victorian community palliative care service recorded their preferred place of death. While most indicated they would prefer to die at home - a much cheaper option than hospital care - only half were able to do so.
The report, titled Palliative Care, said some people in inner metropolitan areas had faced "extended" waits for support at home in the past and that this was likely to happen again as demand continues to increase.
"For a period in 2014, one community service had a waiting list of up to six weeks and did not accept new patients due to a spike in demand and an unexpected staffing shortfall," the report said.
While the department of health and human services stepped in to provide alternative solutions, the report said it was a "far from ideal set of circumstances".
"This remains a major concern for metropolitan inpatient facilities wishing to discharge patients to the community. It could potentially result in patients staying in hospital longer than they want, or receiving basic, non-palliative care in the home, or even re-presenting to hospital if symptoms escalate or become distressing," the report said.
Furthermore, while the investigation reported that Victoria had a strong palliative care sector, with dedicated and skilled staff, a departmental review in 2014 found that most palliative care services did not meet expected standards. Some believed they were better than they really were.
"Going forward, it is imperative that DHHS sets clear expectations for service delivery across the state and provides sufficient and appropriate funding to health services and community organisations," said Auditor-General John Doyle.
The report said uptake of advance care plans that outline people's preferences at the end of life had been slow and that not enough health professionals were initating conversations about death with patients. It said the plans were being used by around half of all patients supported by community palliative care services - a figure that had not changed over time.
The peak body representing such services, Palliative Care Victoria, has called for an extra $10 million to be invested in services.
Chair of the organisation Michael Bramwell said he was pleased the report had also highlighted the need to improve community awareness of palliative care and more support for carers.
About 36 000 people die in Victoria each year and this figure is projected to double in the next 25 years, the report said. Of those people, about half will die after suffering from a chronic illness such as heart disease and cancer or neurological illnesses, such as dementia.
The report said palliative care aims to improve the quality of life of people with terminal illnesses by managing pain and distressing symptoms, and assisting patients to start making choices about how they want to be cared for as they die.
