Figures: Figure 1 – WHO Public Health Model of Palliative Care 15 Figure 2 – The NPPZ matrix 19 Tables: Table 1 – National Palliative Care Strategy 2010 goal areas Table 2 – Overview of the 10 essential elements in the Consensus Statement Table 3 – Evaluation Structure 11 Table 4 – National consultation fieldwork 12 Table 5 – Half Day Workshops 13 Table 6 – Indicators for the quality of death index 16 Table 7 – Ambitions framework 18 Table 8 – Four service provision categories within the Framework for 2009-2013 20 Table 9 – Summary of key findings under the Strategy goal areas 26 Table 10 – Progress against action areas 30 Table 11 – Progress against action areas 32 Table 12 – Progress against action areas 36 Table 13 – Progress against action areas 39 Table 14 – Australian comparison to WHO’s palliative care model 42 Table 15 – Features of a National Palliative Care Strategy 43 Table 16 – Alignment of the National Palliative Care Projects with strategic best practice 47
appropriate policies availability of education and training availability of drugs implementation across all levels of society. These domains are illustrated in the figure following. Figure – WHO Public Health Model of Palliative Care Source: European Association for Palliative Care, 2014. More recently, in 2014 the first international resolution on palliative care called upon WHO and member states to strengthen palliative care “as a core component of health systems”, particularly within primary and community care settings (World Health Organization, 2015). This development led to WHO’s commitment to improve palliative care in the following areas: “integrating palliative care into all relevant global disease control and health system plans developing guidelines and tools on integrated palliative care across disease groups and levels of care, addressing ethical issues related to the provision of comprehensive palliative care supporting Member States in improving access to palliative care medicines through improved national regulations and delivery systems promoting increased access to palliative care for children (in collaboration with UNICEF) monitoring global palliative care access and evaluating progress made in palliative care programmes encouraging adequate resources for palliative care programmes and research, especially in countries building evidence of models of palliative care that are effective in low- and settings” (World Health Organization, 2015). Another important international initiative is the Quality of Death Index, developed by the Economist Intelligence Unit (EIU) . In 2010, the EIU developed an index to assess the availability, affordability and quality of end-of-life in 40 countries. The methodology enabled EIU to rank the quality of the provision of palliative care at a country level, with an initial report released in 2010. A follow-up report was released in 2015, expanded to 80 countries, reflecting around 85% of the world’s population . Most Western countries were included in both study years, including Australia, the US, New Zealand, Canada, the UK, the Netherlands and other European countries. Both study reports provide insights into international best practice regarding palliative care development and implementation strategies and policies. The reports also set out emerging new developments and challenges internationally, as well as examples of successful community-based initiatives and activities. The indicators used to rank countries in the provision of palliative care are instructive as they suggest the fundamental components of effective palliative care; these are shown in the following table. Table 6 – Indicators for the quality of death index Indicator Details Palliative and healthcare Healthcare spending limited income