Clinical resources, training and education

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Palliative Care Therapeutic Guidelines (access via DHHS Clinicians Health Channel)

The electronically published Palliative Care Therapeutic Guidelines (eTG Complete) from independent not-for-profit organisation Therapeutic Guidelines Limited (TGL) provide detailed guidance for health professionals on a wide range of topics.

The eTG guidelines can only be accessed via purchase/paid subscription. Victorian Department of Health and Human Services (DHHS) funded organisations can gain free access via the Department’s Clinicians Health Channel.

https://www2.health.vic.gov.au/CliniciansHealthChannel

Ready for Community Palliative Care (DHHS Vic online resource)

Ready for Community Palliative Care is an online resource of the Victorian Department of Health and Human Services based on work undertaken by a working party of the Victorian Palliative Care Clinical Network (PCCN).

The resource supports acute hospital staff in their discharge planning for patients who are in the last twelve months of life. Patients may be stable, deteriorating, unstable or actively dying.

The aim of the resource is to make discharge safe and secure for patients, families and carers, whether it is to the person’s home, residential aged care or a disability service.

It includes sections on:

https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/end-of-life-care/palliative-care/ready-for-community

Essential elements of end of life care (DHHS Vic online resource)

Essential elements of end of life care is an online resource of the Victorian Department of Health and Human Services (DHHS) based on work undertaken by a working party of the Victorian Palliative Care Clinical Network (PCCN).

The resource is designed to assist acute health services to operationalise the National consensus statement: essential elements for safe and high-quality end-of-life care.

It is a resource for boards, executives, managers and clinicians of all disciplines.

The resource includes sections on:

The resource includes links to another DHHS resource, Ready for Community Care, other Australian based information such as the Ballarat Health Services End of Life framework and the NSW Palliative and End of Life Care Blueprint for Improvement along with international clinical tools such as the Proactive Identification Guidance (PIG) of the Gold Standards Framework and the Supportive and palliative care indicators tool SPICT™).

https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/end-of-life-care/palliative-care/essential-elements

 

AMBER Care Bundle (UK)

The Amber Care Bundle was developed by the Guy’s and St Thomas’ NHS Foundation Trust in London in the UK.

It is designed to assist in managing the care of hospital patients who are facing an uncertain recovery and who are at risk of dying in the next one to two months. It is an intervention that can fit within any care pathway or diagnostic group for patients whose recovery is uncertain.

It does not change a patient’s treatment or care – it helps staff to realise when they should talk with patients about treatment options and care they would prefer.

The tool combines identification questions, four clinical interventions and monitoring that can be applied in adult ward settings.

The AMBER Care Bundle is referenced as part of the Victorian Department of Health and Human Services Ready for Community Palliative Care resource.

http://www.ambercarebundle.org/forprofessionals/for-professionals.aspx

Aged care and palliative care

For aged care and palliative care clinical resources, training and education, including the Residential Aged Care Palliative Approach Toolkit, Decision Assist and hospital-based In-Reach teams, see the aged care and palliative care section of the resources section of this website.

Consortium website resources section on aged care and palliative care

Australian Centre for Grief and Bereavement

The mission of the non-profit Australian Centre for Grief and Bereavement is to build the capacity of individuals, organisations and communities in order to enhance well-being following adverse life events. The Centre is a statewide service with an office located in Mulgrave, Melbourne. The Centre receives funding from the Victorian Department of Health and Human Services as a statewide specialist bereavement service.

Services and resources include:

http://www.grief.org.au/

Australian Commission on Safety and Quality in Health Care

The Australian Commission on Safety and Quality in Health Care (the Commission) was established in 2006 by the Australian, state and territory governments to lead and coordinate national improvements in safety and quality in health care. The Commission’s strategic priorities are in the areas of: patient safety; partnering with patients, consumers and communities; quality cost and value; supporting health professionals to provide safe and high-quality care.

Work program areas include:

https://www.safetyandquality.gov.au/

Australian Institute of Health and Welfare palliative care statistics and data

The Australian Institute of Health and Welfare (AIHW) is an Australian Government body with the formally defined purpose to “create authoritative and accessible information and statistics that inform decisions and improve the health and welfare of all Australians”. The AIHW’s palliative care data includes a range of national and state/territory statistics.

http://www.aihw.gov.au/palliative-care/

Bereavement support standards for specialist palliative care services

The 32 page bereavement support standards document was developed by the Australian Centre for Grief and Bereavement in partnership with the Centre for Palliative Care with funding and other support provided by the Victorian Department of Health and Human Services through the Palliative Care Clinical Network.

The bereavement support standards are designed for use by professionals working in all Victorian government-funded adult specialist palliative care services, including community, inpatient, acute and consultancy services, to assist carers and bereaved individuals with elevated risk of developing prolonged or complicated grief or with current psychosocial and/or spiritual distress.

The standards document includes a section on factors impacting on grief reactions (risk factors and factors that enhance resilience) along with a glossary and resource listing.

A copy of the standards can be found on various websites, including the Australian Centre for Grief and Bereavement.

http://www.grief.org.au/ACGB/ACGB_Publications/Resources_for_Professionals_1/Bereavement_Standards_in_Palliative_Care.aspx

Better Care Victoria, including Innovation Fund projects and Knowledge Hub

Better Care Victoria’s mission is to “enable and support timely and appropriate access to the highest quality of care for Victorians, through the identification, scaling and embedding of innovative practice across Victoria’s health system”.

Better Care Victoria, an agency of the Victorian Department of Health and Human Services, provides funding for healthcare provider-led innovation and improvement projects and supports the development of innovation and improvement capability across Victoria.

Better Care Victoria was established following the 2015 publication of the report Increasing the capacity of the Victorian public hospital system for better patient outcomes (Travis review) and also forms part of the Government’s response to the Targeting Zero: supporting the Victorian hospital system to eliminate avoidable harm and strengthen quality of care report.

The Better Care Victoria Innovation Fund provides project funding to support sector-led innovation projects that demonstrate a strong ability to improve both access to, and the quality of health care across the state. Better Care Victoria’s Knowledge Hub is a repository of information, tools and resources, and a place to connect and share knowledge about work in healthcare innovation and improvement.

Web: https://www.bettercare.vic.gov.au/

Better Health Channel information on end of life and palliative care

Better Health Channel is a Victorian Government website that aims to help people understand and manage their health and medical conditions. The end of life and palliative care section of Better Health Channel includes a range of information on topics such as ‘end of life and palliative care explained’ and ‘practical care to assist family and carers’.

https://www.betterhealth.vic.gov.au/palliative

CareSearch - evidence based palliative care website with information and resources

CareSearch is an evidence palliative care based website developed at Palliative and Supportive Services, Flinders University funded by the Australian Government. CareSearch includes information for health professionals, aged and other community services workers, academics, researchers and for people with a life limiting illness and their carers and family.

CareSearch includes information for:

Web: https://www.caresearch.com.au/Caresearch/Default.asp

Care Plan for the Dying Person - Victoria

The Care Plan for the Dying Person – Victoria (CPDP-Vic) is designed for bedside use in acute hospitals for people who are imminently dying (last days and hours of life). Funded by the Victorian Government and developed by the Victorian End-of-life Care Coodinating (VEC) Program under the auspice of the Centre for Palliative Care, the CPDP-Vic is organised in six sections: Recognising dying; Medical review of care needs; Planning individualised care; Delivery of care; Care after death; Care plan discontinued. The clinical resources and information related to successful implementation can be accessed on the VEC website.

http://www.vec.org.au/

Centre for Palliative Care

The Centre for Palliative Care is part of St Vincent’s Hospital Melbourne and is a Collaborative Centre of The University of Melbourne. The Centre’s website includes:

The Centres education and training opportunities include:

https://www.centreforpallcare.org/

Clinical guidelines for adults in the terminal phase (WA Cancer and Palliative Care Network)

Evidenced based clinical guidelines in the terminal phase (2nd edition, 2010) is published by the WA Cancer and Palliative Care Network. It is organised in a colour coded ‘flipchart’ style in five sections: Dyspnoea (Community and Inpatient); Nausea and Vomiting; Pain; Respiratory Tract Secretions; Terminal Restlessness/Agitation.

http://www.healthnetworks.health.wa.gov.au/cancer/docs/Evidence_based_guidelines_2011.pdf

Communication skills training for NW Metro specialist palliative care service staff

Through the North and West Metropolitan Region Palliative Care Consortium, free communication skills training in ‘Eliciting and responding to emotional cues’ is available for all specialist palliative care staff.

The training is based on the Victorian Cancer Clinicians Communication Program (VCCCP) of Cancer Council Victoria. ‘Emotional Cues’ is designed as a foundation course. Other VCCCP topics include: Breaking bad news: Discussing the transition to palliative care; Discussing sexuality and cancer; Discussing death and dying.

During 2017-18, the Consortium is considering options for the development of a new series of ‘advanced communication’ workshops to assist community palliative palliative in working with difficult situations in the home environment.

http://northwestpalliative.com.au/what-we-do/other-consortium-projects/

Conferences - in Australia (Upcoming)

Palliative Care Australia, Australian Palliative Care Conference: Connection with Community

Date: 6-8 September 2017

Location: Adelaide Convention Centre, North Terrace, Adelaide, Australia

http://pca2017.org.au/

Conferences - International (Upcoming)

International Society for Advance Care Planning and End of Life Care Conference

Date: September 6-9, 2017

Location: Banff, Alberta, Canada

https://www.acpel2017.org/

Second International Conference on End of Life Law, Ethics, Policy and Practice

Date: September 13-15, 2017

Location: Halifax, Nova Scotia, Canada

http://icel2halifax.ca/

5th International Public health and Palliative Care Conference. Palliative Care IS Public Health: Principles to Practice

Date: September 17-20, 2017

Location: Ottowa, Canada

http://www.iphpc2017.com/

Conferences - International (Past)

Asia Pacific Hospice Conference

Date: July 26-29, 2017

Location: Singapore

http://www.aphc2017.org/

International Association of Gerontology and Geriatrics (IAGG) World Congress of Gerontology and Geriatrics

*Included a key note presentation on: Palliative care in the mainstream stepping up to the plate: The case for integrated geriatric and palliative care strategies.

Date: July 23-27, 2017

Location: San Francisco

https://www.iagg2017.org/

ICELC 2017: 19th International Conference on End of Life Care

Date: June 28-29, 2017

Location: Dubai, UAE

https://waset.org/conference/2017/06/dubai/ICELC

Disease specific information and support organisations

Better Health Channel information on conditions and treatments

Better Health Channel is a Victorian Government website that aims to help people understand and manage their health and medical conditions. Better Health Channel includes a range of pages on conditions and treatments, including cancer, heart disease, Chronic Obstructive Pulmonary Disease (COPD), Kidney Disease, Liver Disease, General Neurological Diseases, Parkinson’s Disease, Motor Neurone Disease, Multiple Sclerosis, Frailty, Dementia, Stroke.

https://www.betterhealth.vic.gov.au/conditionsandtreatment

Cancer Council Australia

The Cancer Council Australia website offers the following information:

The website notes that additional information for health professionals can be found on the website of Cancer Council Australia’s affiliated clinical partner, the Clinical Oncology Society of Australia, the peak national body representing health professionals working in cancer.

http://www.cancer.org.au/ 

Cancer Council Victoria

In addition to a section for health professionals, the Cancer Council Victoria website includes sections on:

http://www.cancervic.org.au/

Heart Foundation

The Heart Foundation website includes:

The Heart Foundation also runs a Health Information Service 1300 36 27 87 that provides free personalised information and support on heart health, nutrition and a healthy lifestyle.

https://heartfoundation.org.au/

Lung Foundation Australia

The Lung Foundation website includes:

Lung Foundation Australia is part of the Lung Health Alliance, a collective of national respiratory not-for-profit organisations working together to improve the lung health of individuals and communities in Australia and to contribute to the global effort for lung health. The other members of the alliance include: Asthma AustraliaAustralian respiratory councilCystic Fibrosis AustraliaNational Asthma Council AustraliaThe Thoracic Society of Australia and New Zealand.

Lung Foundation Australia also runs an Information and Support Centre on freecall 1800 654 301.

http://lungfoundation.com.au/

Kidney Health Australia

The Kidney Health Australia website includes sections on:

There is also a section for Health Professionals with a range of information, including:

http://kidney.org.au/

Liver Disease – Cirrhosis of the liver

Better Health Channel is a Victorian Government website that aims to help people understand and manage their health and medical conditions. Better Health Channel includes a page on ‘Cirrhosis of the liver’ with information on various topics including: symptoms, causes, complications, diagnosis and treatment.

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cirrhosis-of-the-liver

Neurological disorders

There Brainfacts website offers an A-Z listing of neurological disorders, based on information from the American based National Institute of Neurological Disorders and Stroke (NINDS).

http://www.brainfacts.org/diseases-disorders/diseases-a-to-z-from-ninds/

Parkinson’s Australia

The Parkinson’s Australia website includes:

In association state/territory based associations, including Parkinson’s Victoria, Parkinson’s Australia runs a freecall information line 1800 644 189.

http://www.parkinsons.org.au/

Parkinson’s Victoria

The Parkinson’s Victoria website includes a range of information for those living with Parkinson’s, their families and carers, peer support groups and health care professionals.

Parkinson’s Victoria also service Victorian calls the to the national freecall information line of Parkinson’s Australia on 1800 644 189.

http://www.parkinsonsvic.org.au/

Motor Neurone Disease (MND) Australia

MND Australia describes itself as “the national voice representing all Australians who share the vision of a world without MND”, working with a national network state/territory MND associations, including MND Victoria to advocate, educate and raise awareness. MND Australia’s goal is to empower Australians impacted by MND to live better for longer.

The MND Australia website includes a wide range of information, including the MNDcare website designed for health, disability, aged and community care professionals, which includes access to MND Aware online training.

http://www.mndcare.net.au/Home.aspx and https://www.mndaust.asn.au

Motor Neurone Disease (MND) Victoria

MND Victoria is affiliated with MND Australia and provides and promotes the best possible care and support for people living with Motor Neurone Disease (MND). This includes a range of information about services to support people with MND and other pages designed for friends and family and health professionals.

https://www.mnd.asn.au/

Multiple Sclerosis Australia

The MS Australia website includes sections on:

https://www.msaustralia.org.au/

Department of Health and Human Services on older people in hospital and frailty

The older people in hospital section of the Victorian Department of Health and Human Services (DHHS) includes a section on frailty, with information on screening and assesment for frailty and responding to frailty.

The site also offers links to further information including:

https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/older-people/frailty

Alzheimer’s Australia website

The Alzheimer’s Australia website provides access to a wide range of resources for health professionals and people affected by dementia and their carers, families and friends, including:

The ‘About dementia and memory’ loss section of the site also includes a series of ‘Help Sheets’ on different topics in dementia.

https://www.fightdementia.org.au/ (national) or https://vic.fightdementia.org.au/ (Victoria)

Stroke Foundation Australia

The Foundation website includes detailed information about stroke and a what we do section with information on prevention, support and treatment programs, along with research.

The Foundation runs two additional websites:

  • Inform me is a dedicated website resource for health professionals to improve the treatment of stroke care. Membership is offered to health professionals working in stroke care, including those currently studying.
  • Enable me is a website designed to provide information, tips and techniques to equip people in their stroke recovery.

https://strokefoundation.org.au/

Stroke Association of Victoria

The Stroke Association of Victoria (SAV) is the only dedicated community based support service for people re-entering their lives after having a stroke. SAV has representatives across metropolitan and regional Victoria and is focused on ensuring community inclusion for stroke survivors, teaching independent living skills and sharing self-managed rehabilitation techniques.

http://www.strokeassociation.com.au/

Dying2Learn MOOC (massive open online course)

A free five week online course run by Caresearch, the Dying2Learn MOOC (massive open online course) considers different ideas and societal thinking around dying and death in the 21st century, including:

  • The language we use when we talk about dying.
  • How and what people die from now.
  • How art, music, and media have shaped our ideas on death.
  • What happens in the digital world when we die.

https://www.caresearch.com.au/caresearch/tabid/2868/Default.aspx

End-of-life Essentials: education for acute hospital staff

A project of Flinders University, End-of-life Essentials provides e-learning and resources for doctors, nurses and allied health professionals to improve the quality and safety of end of life care in hospitals.

The content of End of Life Essentials has been informed by the National Consensus Statement ‘Essential elements for safe and high-quality end-of-life care’ of the Australian Commission on Safety and Quality in Health Care and is relevant to implementation of the end of life care components of the Commission’s National Safety and Quality Health Service Standards.

https://www.caresearch.com.au/Caresearch/tabid/3866/Default.aspx

Essential palliative care medication lists for community pharmacists and general practitioners

This medication guide for community pharmacists and general practitioners was published in 2011 by the WA Cancer and Palliative Care Network.

http://www.healthnetworks.health.wa.gov.au/cancer/docs/EPCMLfCPaGPs.pdf

Gold Standards Framework Centre in End of Life Care (UK)

The National Gold Standards Framework (GSF or Gold Standards) Centre in End of Life Care is a UK based not-for-profit Social Enterprise Community Interest Company.

The GSF website provides access to a range of resources, including the Proactive Identification Guidance (PIG) to support earlier identification of patients nearing the end of life.

http://www.goldstandardsframework.org.uk/home

Grief and bereavement

Understanding Grief (Palliative Care Australia booklet)

The Understanding Grief booklet published by Palliative Care Australia explains what grief is, the thoughts, feelings and sometimes physical reactions a person can experience and where to find further help.

http://palliativecare.org.au/understanding-grief/

Community palliative care services grief and bereavement support

All community palliative care services provide access to grief and bereavement support for carers and family members. This can extend to 13 months after death.

For specific details of the grief and bereavement support provided by the three community palliative care services in the NW Metro region, contact directly:

Hospital based specialist palliative care services grief and bereavement support

Unlike community palliative care services, access to long term bereavement support for people who need it is not part of the service model for hospital based specialist palliative care services.

The grief and bereavement support available through hospitals will vary from service to service and will depend on availability of staff from the hospital’s allied care team.

For specific details of the grief and bereavement support provided by the specialist palliative care services of public hospitals in the NW Metro region, contact directly:

The Australian Centre for Grief and Bereavement (Bereavement Counselling and Support Service)

The Australian Centre for Grief and Bereavement (ACGB) operates a statewide bereavement counselling and support service for Victoria. The program is funded by the Victorian Government Department of Health and Human Services and provides support for people experiencing grief and bereavement as well as bereavement advice and consultation for workers from other settings to assist their work with people experiencing grief and bereavement.

Services include: counselling; support groups; written resources; remembrance events; practitioner consultation and support. Bereavement counselling is available for anyone in the community, including children and adolescents, who need support following the death of someone close to them. ACGB charges fees in accordance with a schedule dependent on income and personal circumstances.

http://www.grief.org.au/

National Carer Counselling Program (accessed via Carers Victoria)

The National Carer Counselling Program provides free of charge short-term counselling (up to six sessions) on issues related to a person’s caring role, including all palliative care situations and bereavement. In Victoria the program is organised by Carers Victoria.

https://www.carersvictoria.org.au/how-we-help/counselling/about-counselling

GriefLine

GriefLine provides counselling support services free of charge to individuals and families, including: telephone support; online counselling; and in-house one on one counselling.

http://griefline.org.au/

Bereavement support standards for specialist palliative care services

The 32 page bereavement support standards document was developed by the Australian Centre for Grief and Bereavement in partnership with the Centre for Palliative Care with funding and other support provided by the Victorian Department of Health and Human Services through the Palliative Care Clinical Network.

The bereavement support standards are designed for use by professionals working in all Victorian government-funded adult specialist palliative care services, including community, inpatient, acute and consultancy services, to assist carers and bereaved individuals with elevated risk of developing prolonged or complicated grief or with current psychosocial and/or spiritual distress.

The standards document includes a section on factors impacting on grief reactions (risk factors and factors that enhance resilience) along with a glossary and resource listing.

A copy of the standards can be found on various websites, including the Australian Centre for Grief and Bereavement.

http://www.grief.org.au/ACGB/ACGB_Publications/Resources_for_Professionals_1/Bereavement_Standards_in_Palliative_Care.aspx

HealthPathways Melbourne (for GP teams)

HealthPathways Melbourne, an initiative of the Eastern Melbourne Primary Health Network (EMPHN) and North Western Melbourne Primary Health Network (NWMPHN), is an online portal designed to be used at the point of care by GP teams working in the northwest and eastern regions of Melbourne.

HealthPathways aims to guide best-practice assessment and management of common medical conditions and includes detailed information and links on palliative care topics.

https://melbourne.healthpathways.org.au

Integrated Cancer Services and the Victorian Cancer Plan 2016-2020

Victoria’s Integrated Cancer Services (ICS) are the Victorian Cancer Clinical Network and comprise clusters of hospitals and associated health services that deliver care for people with all types of cancers within a geographic area, including public hospitals, community-based services, general practitioners and other primary health organisations, private hospitals and supportive care services.

Within the context of the Victorian Cancer Plan 2016-2020, the role of the ICS is to build relationships, implement best practice models of care, improve the effectiveness of cancer care and monitor systems and processes to improve performance.

Victorian ICS include:

Other Victorian ICS are:

https://www2.health.vic.gov.au/about/health-strategies/cancer-care/integrated-cancer-services

Listen, Acknowledge, Respond: Addressing the mental health concerns of those living with dying

Listen, Acknowledge, Respond (LAR) is an Australian Government funded collaboration between Charles Sturt University, Amaranth Foundation and integratedliving Australia designed to identify and build the capacity of the mental health, allied health, social work and other health care workers (in primary and specialist settings) to support end of life psychosocial and psychological care needs for people with advanced chronic and life limiting illnesses, their families and care givers. Activities include ‘Mind The Gap’ professional development courses.

http://listenacknowledgerespond.com.au/

Medicinal Cannabis - Victorian and national legislation and policy framework

Following the Victorian Parliament’s passing of The Access to Medicinal Cannabis Act 2016The Office of Medicinal Cannabis within the Department of Health and Human Services (DHHS) has been established to oversee the operation of Victoria’s medicinal cannabis framework.

From a patient/clinician perspective, it is necessary to understand how the Victorian legislation interacts with national drug laws regarding the cultivation, manufacture and supply of medicinal cannabis products. These national laws and regulations are overseen by the Australian Government Office of Drug Control and the Therapeutic Goods Administration (TGA).

In summary:

  • All legal pathways to accessing medicinal cannabis require the support and monitoring of a treating medical team, who need to seek and obtain the appropriate approvals on behalf of the patient.
  • The key gateways to accessing medicinal cannabis are the Special Access Scheme (SAS) and Authorised Prescriber (AP) processes of the TGA. See the TGA’s ‘Access to medical cannabis products in Australia: Resource for doctors’, for a one page diagrammatic summary.
  • All patients eligible for the new Victorian scheme will still need to go through the TGA approvals process (i.e. the Victorian and Australian Government schemes, although independent, operate together in a complementary way).
  • The initial priority patient group for access to medicinal cannabis under the Victorian legislation is children with severe intractable epilepsy. Eligible patient groups under the Victorian legislation may be expanded in the future based on the advice of an Independent Medical Advisory Committee.
  • The TGA’s SAS and AP processes are not restricted to the Victorian eligible patient group – a doctor may apply to the TGA for special access for patients with any indication for whom they believe treatment with medicinal cannabis is appropriate.
  • The TGA may also allow access to medicinal cannabis for the purposes of clinical trials, which may be conducted to develop an evidence base to support safety and efficacy of medicinal cannabis.

In addition to considering types of patients eligible for medicinal cannabis, both the national and Victorian legislation include a considerable focus on processes for the cultivation and supply of medicinal cannabis. This includes importation and the production of medicinal cannabis in Australia. For example, under the TGA SAS/AP processes, if stock is available in Australia (Step 3A in ‘Access to medical cannabis products in Australia: Resource for doctors’) access tends to be significantly quicker and easier than if product must be imported (Step 3B).

Accordingly, the Victorian legislation is partly about encouraging the development of a new local/Victorian supply of medicinal cannabis products and reducing the need to source imported products.

In summary, from a Victorian scheme ‘supply of product’ perspective:

  • Once a local/Victorian supply of medicinal cannabis is established, the Victorian legislation directs that access to this supply is restricted to the groups specified as eligible (currently children with severe intractable epilepsy).
  • Other groups of people considered in need of medicinal cannabis by their doctors will not be eligible to access the local/Victorian manufactured supply, except in exceptional circumstances. Rather, via the TGA SAS/AP processes referenced above, doctors will need to access supply from sources other than the Victorian scheme.
  • Note: The doctors of Victorian scheme eligible children also need to gain approval via the TGA SAS/AP processes before being able to access the local/Victorian product.

The Frequently Asked Questions (FAQ) of the DHHS Office for Medicinal Cannabis includes further information on a range of topics, including:

  • What is the Victorian Access to Medicinal Cannabis Scheme?
  • How does the Victorian Access to Medicinal Cannabis Scheme interact with Commonwealth medicinal cannabis legislation?
  • What is medicinal cannabis?
  • What are the benefits of medicinal cannabis?
  • Is there a difference between cannabis/marijuana and medicinal cannabis?
  • Who can access medicinal cannabis?
  • When will additional eligible patient groups be added?
  • How do I apply?
  • I am not an eligible patient under the Victorian scheme. Can I still access medicinal cannabis?
  • Is it now legal for me to smoke cannabis for medicinal purposes?
  • I have found medicinal cannabis products available online. Are these products legal?

The DHHS Office of Medicinal Cannabis website also includes links to the Victorian Law Reform Commission report on medicinal cannabis that was tabled in parliament in October 2015, along with recently published research on medicinal cannabis.

 

Web: https://www2.health.vic.gov.au/public-health/drugs-and-poisons/medicinal-cannabis

National Consensus Statement: Essential elements for safe and high quality end-of-life care

The National Consensus Statement ‘Essential elements for safe and high-quality end-of-life care’ was published in 2015 by the Australian Commission on Safety and Quality in Health Care. The Consensus Statement aligns with the Commission’s National Safety and Quality Health Service Standards but provides recommended, rather than mandatory, practice. It also aligns with the National consensus statement: essentials elements for safe and high-quality paediatric end-of-life care and the National consensus statement: essential elements for recognising and responding to acute physiological deterioration. It is intended that these documents be applied together.

The 44 page Consensus Statement includes sections on:

  • Guiding principles
  • Patient-centred communication and shared decision-making
  • Teamwork and coordination of care
  • Components of care
  • Use of triggers to recognise patients approaching the end of life
  • Response to concerns
  • Organisational prerequisites
  • Leadership and governance
  • Education and training
  • Supervision and support for interdisciplinary team members
  • Evaluation, audit and feedback
  • Systems to support high-quality care

https://www.safetyandquality.gov.au/our-work/end-of-life-care-in-acute-hospitals/ and   https://www.safetyandquality.gov.au/publications/national-consensus-statement-essential-elements-for-safe-high-quality-end-of-life-care/

National Safety and Quality Health Service Standards (End of life care components)

The Draft National Safety and Quality Health Service Standards of the Australian Commission on Safety and Quality in Health Care (the Commission) call for processes supporting comprehensive care at the end of life (5.15-5.20 on page 42) that are consistent with the Commission’s National Consensus Statement: Essential elements for safe and high-quality end-of-life care.

https://www.safetyandquality.gov.au/wp-content/uploads/2016/07/DRAFT-National-Safety-and-Quality-Health-Service-Standards-version-21.pdf

Opioid conversions; syringe driver compatibilities; respiratory secretions

These resources are available from the website of the Eastern Metropolitan Region Palliative Care Consortium (EMRPCC)

Opioid Conversion Ratios: Guide to Palliative Care Practice (2016 version, May 3)

http://www.emrpcc.org.au/wp-content/uploads/2016/05/Opioid-Conversions-May-3-2016-final.pdf

Syringe Driver Drug Compatibilities – Guide to Palliative Care Practice (2016 version, May 3)

http://www.emrpcc.org.au/wp-content/uploads/2016/05/Syringe-Driver-Drug-Compatibilities-2016-May-3-final.pdf

Management of respiratory secretions in the terminal phase (2016 version, May 3) 

http://www.emrpcc.org.au/wp-content/uploads/2016/05/Respiratory-Secretions-Terminal-Phase-May-3-2016.pdf

 

Noisy breathing at the end of life, a pamphlet for families

http://www.emrpcc.org.au/wp-content/uploads/2016/05/Noisy-Breathing-Familyleaflet2016.pdf

Optimal Cancer Care Pathways for health professionals

Optimal cancer care pathways (OCPs) have been developed under the auspice of Cancer Council Victoria. OCPs describe the optimal cancer care for specific tumour types. They map the patient journey, aiming to foster an understanding of the whole pathway and its distinct components, to promote quality cancer care and patient experiences.

The documents identify specific steps, or critical points along the care pathway and the recommended care at each point.

http://www.cancervic.org.au/for-health-professionals/optimal-care-pathways

Paediatric Palliative Care, including RCH, Basic Symtpon Contol clinical tool and QuoCCA

The Victorian Paediatric Palliative Care Program (VPPCP)

The VPPCP section of the Royal Children’s Hospital website provides a range of information and links about paediatric palliative care, including ‘Basic Symptom Control in Paediatric Palliative Care’, a clinical tool published by the UK non-profit organisation Together for short lives.

http://www.rch.org.au/rch_palliative/

Basic Symptom Control in Paediatric Palliative Care (a worldwide clinical tool published in the UK)

Basic Symptom Control in Paediatric Palliative Care is a clinical tool published by the UK non-profit organisation Together for short lives.

http://www.togetherforshortlives.org.uk/professionals/resources/2434_basic_symptom_control_in_paediatric_palliative_care_free_download

Quality of Care Collaborative for Australia in Paediatric Palliative Care (QuoCCA).

Further information and training about paediatric palliative care is available as part of the Australian Government funded project, Quality of Care Collaborative for Australia in Paediatric Palliative Care (QuoCCA).

https://www.caresearch.com.au/caresearch/tabid/3682/Default.aspx

National consensus statement on essential elements for safe and high-quality paediatric end-of-life care

The National Consensus Statement ‘Essential elements for safe and high-quality paediatric end-of-life care’ was published in 2016 by the Australian Commission on Safety and Quality in Health Care. The Consensus Statement aligns with the Commission’s National Safety and Quality Health Service Standards but provides recommended, rather than mandatory, practice. It also aligns with the National consensus statement: essentials elements for safe and high-quality end-of-life care and the National consensus statement: essential elements for recognising and responding to acute physiological deterioration. It is intended that these documents be applied together.

The 44 page page paediatric national consensus statement includes

  • Guiding principles
  • Family-centred communication and decision-making
  • Teamwork and coordination of care
  • Use of triggers to recognise children approaching the end of life

https://www.safetyandquality.gov.au/publications/national-consensus-statement-essential-elements-for-safe-and-high-quality-paediatric-end-of-life-care/

 

After the Loss of a Child: A Resource for Parents of Children in Palliative Care

After the Loss of a Child: A Resource for Parents of Children in Palliative Care is a 32 page booklet published by the Australian Centre for Grief and Bereavement. It is designed for parents of children in palliative care, but is also a useful resource for any parent who experiences the loss of a child.

The booklet looks at common issues and processes occurring both before and after the death, and provides information and helpful tips for navigating the grief experience of parents and families both immediately and in the long term. It includes sections on:

  • Before the death
  • After the death
  • Grief
  • Grief and relationships
  • Parenting after the loss of a child
  • Grief over time
  • Seeking help

http://www.grief.org.au/ACGB/ACGB_Publications/Paediatric_Palliative_Care.aspx

Palliative Care Australia

The “I’m a health professional” section of the website of Palliative Care Australia has a range of information and links for health professionals involved in supporting people with life-limiting illness and their families.

http://palliativecare.org.au/im-a-health-professional/

Palliative Care Clinical Network (PCCN)

The Palliative Care Clinical Network (PCCN) is one of 10+ clinical networks that are part of The Victorian Government’s Safer Care Victoria initiative. The PCCN provides clinical leadership in the implementation of policy directions and program initiatives in Victoria and undertakes projects to enhance the availability of clinical tools and resources for palliative care.

https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/end-of-life-care/palliative-care/palliative-care-clinical-network

Palliative Care Clinical Studies Collaborative (PaCCSC)

The Palliative Care Clinical Studies Collaborative (PaCCSC) is an Australian Government national research network run by Flinders University that aims to:

  • Generate high quality research evidence to support the use of medicines and other interventions at the end of life to better manage or alleviate symptoms in patients such as: pain; confusion; breathlessness; appetite; and gastrointestinal problems including nausea; bowel obstruction; and constipation.
  • Build capacity within the health workforce in the conduct of high quality clinical research in patients nearing the end of life and the translation of research results into clinical practice.

https://www.caresearch.com.au/Caresearch/tabid/2476/Default.aspx

Palliative Care Curriculum for Undergraduates (PCC4U)

PCC4U is an Australian Government funded project led by Queensland University of Technology in collaboration with the Queensland Government, Flinders University and Curtin University of Technology. It promotes the inclusion of palliative care education as an integral part of all medical, nursing, and allied health undergraduate and entry to practice training, and ongoing professional development.

http://www.pcc4u.org/

Palliative Care Outcomes Collaboration

The Palliative Care Outcomes Collaboration (PCOC) is a national program run by the Australian Health Services Research Institute (AHSRI) of the University of Wollongong. PCOC utilises standardised clinical assessment tools to measure and benchmark outcomes in palliative care. Participation in PCOC is voluntary and can assist palliative care service providers to improve practice. This PCOC website outlines how this is achieved through an outcome improvement framework which is designed to:

  • provide clinicians with the tools to systematically assess individual patient experiences using validated clinical assessment tools,
  • define a common clinical language between palliative care providers to support assessment and care planning,
  • facilitate the routine collection of national palliative care data to drive quality improvement through reporting and benchmarking,
  • provide regular patient outcomes reports and workshops to facilitate service-to-service benchmarking, and
  • support research using the PCOC longitudinal database.

The PCOC data set includes the clinical assessment tools: Palliative Care Phase, Palliative Care Problem Severity Score (PCPSS), Symptom Assessment Scale (SAS), Australia-modified Karnofsky Performance Status (AKPS) Scale and Resource Utilisation Groups – Activities of Daily Living (RUG-ADL).

Participation in PCOC can also provide evidence for organisations and palliative care services to meet core actions in the National Safety and Quality Health Service Standards.

Web: Palliative Care Outcomes Collaboration (PCOC) homepage

 

Palliative Care Victoria

The “For Healthcare Professionals” section of the website of Palliative Care Victoria has a range of information and links for health professionals involved in supporting people with life-limiting illness and their families.

http://www.pallcarevic.asn.au/healthcare-professionals/

Palliative matters: Stories about living, dying and palliative care (Palliative Care Australia)

‘Palliative matters: Stories about living, dying and palliative care’ is a Palliative Care Australia initiative available through their website and/or via a free email email subscription. It provides a range of articles and stories from people living with a life-limiting illness, carers and friends, health professionals and others.

http://palliativecare.org.au/palliative-matters/

Palliverse

Palliverse describes itself as a place where:

  • Like-minded people involved in palliative care meet;
  • Ideas and issues related to palliative care are exchanged and discussed; and
  • Funding opportunities are explored and shared.

https://palliverse.com/

Program of Experience in the Palliative Approach (PEPA)

The Program of Experience in the Palliative Approach (PEPA) is a nationally funded program run in Victoria by the Centre for Palliative Care.

Victorian PEPA aims to improve the accessibility of quality palliative care in the community by increasing the skills and confidence of health professionals who are caring for people with serious illness, and their families.

PEPA activities include:

  • Workshops on the palliative approach
  • Supervised clinical placements
  • Post-placement support activities

http://pepavic.org.au/

Proactive Identification Guidance (PIG) from the Gold Standards Framework (UK)

The Proactive Identification Guidance (PIG) is a short document designed to provide guidance for clinicians to support earlier identification of patients nearing the end of their life and to look at the supportive care needs for that person.

The guide includes a section on ‘Specific clinical indicators’ for the three disease group trajectories of Cancer, Organ failure and Frailty, dementia, multi-morbidity.

To access more information about the guide and to download a copy (separate registration process required), visit the Gold Standards Framework website.

http://www.goldstandardsframework.org.uk/pig

Safer Care Victoria

Safer Care Victoria is the peak state authority for leading quality and safety improvement in healthcare. Safer Care Victoria oversees and supports health services to provide safe, high-quality care to patients “every time, everywhere”.

Created in response to the recommendations within the report Targeting Zero: supporting the Victorian hospital system Safer Care Victoria works to eliminate avoidable harm and strengthen quality of care.

Staffed and led by clinicians and researchers, Safer Care Victoria provides secretariat support for the Victorian Clinical Council and works closely with the Victorian Agency for Health Information and the Department of Health & Human Services. The operation of the Palliative Care Clinical Network (PCCN) transferred to Safer Care Victoria in 2017.

https://www2.health.vic.gov.au/hospitals-and-health-services/safer-care-victoria

SCTT Templates (forms)

SCTT is an acronym for Service Coordination Tool Templates, a suite of templates developed as part of the Victorian Department of Health and Human Services service coordination framework to support service coordination among health and human services providers, including community palliative care services.

The SCTT provides information and data standards, so service providers and the department can electronically share standardised information. Service providers can use the SCTT to collect and record an initial contact with a person, do an initial needs identification, refer the person, and coordinate the person’s care across services and over time.

The suite of SCTT templates includes:

  • A range of core referral templates including SCTT referral cover sheet and SCTT summary and referral information
  • Other templates including SCTT palliative care supplementary information

https://www2.health.vic.gov.au/primary-and-community-health/primary-care/integrated-care/service-coordination/sctt-forms

 

 

Supportive and Palliative Care Indicators Tool (SPICT™) University of Edinburgh (UK)

The Supportive and Palliative Care Indicators Tool (SPICT™) was developed by the University of Edinburgh to:

  • Help identify people whose health is deteriorating
  • Assess them for unmet supportive and palliative care needs
  • Plan care

The SPICT™ includes clinical indicators for: cancer; dementia/frailty; neurological disease; heart/vascular disease; respiratory disease; kidney disease; liver disease; other conditions.

It is referenced as part of the Victorian Department of Health and Human Services (DHHS) online resources Ready for Community Palliative Care and Essential elements of end of life care.

The SPICT™ can be downloaded free of charge via a registration process.

http://www.spict.org.uk/

The Palliative Care Bridge (NSW based)

The Palliative Care Bridge is a statewide-NSW palliative care education program coordinated and delivered by the HammondCare consortium, comprising HammondCare, Sacred Heart Health Service and Calvary Healthcare Sydney.

The Resources section of the Palliative Care Bridge website includes educational videos on a wide variety of palliative care topics.

The website also includes links to books for purchase, including HammondCare’s The Palliative Care Handbook and The Pain Book.

http://www.palliativecarebridge.com.au/

Victorian Palliative Care Nurse Practitioner Collaborative

Run by the Centre for Palliative Care, the Victorian Palliative Care Nurse Practitioner Collaborative (the Collaborative) provides individual Nurse Practitioners and Nurse Practitioner candidates with educational resources, a mentorship program and networking opportunities, as well as assisting with the development of the Palliative Care Nurse Practitioner (NP) role in Victoria. The Collaborative is funded by the Victorian Department of Health and Human Services, which also offers scholarships to nurses who are completing Masters (Nurse Practitioner) programs.

https://www.centreforpallcare.org/page/38/nursing-vpcnpc

Victorian Palliative Medicine Training Program (VPMTP)

Funded by the Victorian Department of Health and Human Services and run as part of the Centre for Palliative Care, the Victorian Palliative Medicine Training Program (VPMTP) aims to build and sustain a high quality palliative medicine workforce in Victoria. This includes providing palliative care specialists, as well as doctors from other specialities, with the necessary knowledge and skills to practice palliative medicine as part of their clinical workload. VPMTP runs a range of workshops and mentoring programs, along with advanced specialist training in palliative medicine.

http://www.vpmtp.org/