Figure 4: Projected Annual Deaths and Change, 2010-2061 Deaths 60,000 Change Deaths Annual Change 1,800 50,000 1,500 40,000 1,200 30,000 900 20,000 600 10,000 300 0 0 Palliative Care Need/Demand The number of potential palliative care patients is based on the workforce model developed by HWNZ (figure 5). This model is based on evidence4, expert opinion and tested against current numbers of palliative patients in New Zealand. This was also discussed with the New Zealand Palliative Care Council who is doing work on palliative care need5. The assumes that 90% of people with cancer and 40% of people with chronic disease would require some level of palliative care: Figure 6 (p. 11) shows that from 2010-2061 just over half (55%) of the people that died would have required prior palliative care. It also shows that the number of deaths is projected to increase by 96% during 2010- 2061 and a similar increase in palliative care patients Figure 7 shows that from 2010 to 2026 there is approximately a 24% increase in palliative care patients Figure 8 illustrates the regional variation in the numbers of palliative 4 Rosenwax R, McNamara, Blackmore A, Holman C, Estimating the size of a potential palliative care population, The University of Western Australia; Palliative Medicine 2005, 19: 556-562 5 It is acknowledge that when the Palliative Care Council’s final report on the needs analysis is completed it will continue to inform the development of palliative care services and its
Table 2: Palliative Care Workforce by Occupation, 2007/2008 financial year Occupation Hospice Hospital Hospice+Hospital FTEs Head Counts FTEs Head Counts FTEs Head Counts Medical Specialist MOSS Registrar GP with special interest Other medical Medical 17.1 30 8.3 16 4.0 6 10.3 27 1.8 7 41.5 86 12.4 17 0.6 1 5.3 6 - - - - 18.3 24 29.5 47 8.9 17 9.3 12 10.3 27 1.8 7 59.9 110 Nurses Nurse Practitioner Clinical Nurse Specialist Registered Nurse Enrolled & Other Nurse Total Nurses 0.0 0 49.1 62 246.6 431 55.5 87 351.2 580 1.0 1 24.1 28 - - - - 25.1 29 1.0 1 73.2 90 246.6 431 55.5 87 376.3 609 Allied Health Physiotherapist Social Worker Pharmacist Occupational Therapy Dietician Other Allied Health Total Allied 0.8 1 15.7 24 2.4 7 5.1 7 0.4 1 3.4 7 27.8 47 - - 1 1 - - 0.8 1 0.0 0 0.5 2 2.3 4 0.8 1 16.7 25 2.4 7 5.9 8 0.4 1 3.9 9 30.1 51 Total PC Workforce 420.5 713 45.7 57 466.2 770 FTEs: Full-Time Equivalent employees. Source: Gap Analysis Survey, year June 2008 Figure 9 (p.16) shows that at the time of the Ministry of Health survey11, nurses formed the highest proportion of palliative care staff (376, 81%). Table 3 illustrates the large variation in workforce numbers between regions12. The number of FTEs per 1000 patients varies between 20.7 per 1,000 (Upper South Island) to 42.2 per 1,000 (Central Region) with the average being 27.9 per 1,000. 11 Ibid 12 Note that the regions referred to are those outlined in Section 5 as part of the review team’s proposed regional palliative care managed clinical networks.
Table 4: DHBs within Regional Palliative Care Networks Palliative Care Managed Clinical Networks Constituent District Health Boards 1. Northland & Waitemata Northland DHB Waitamata DHB 2. Auckland Auckland DHB 3. Counties Manukau Counties Manukau DHB 4. Waikato & Bay of Plenty Waikato DHB Lakes DHB Bay of Plenty DHB 5. Mid-Central Tairawhiti DHB Taranaki DHB Hawke's Bay DHB Whanganui DHB MidCentral DHB 6. Central Hutt Valley DHB Capital & Coast DHB Wairarapa DHB 7. South Island Nelson Marlborough DHB West Coast DHB Canterbury DHB South Canterbury DHB 8. South Island Southern DHB Figure 13: Population by Palliative Care Network Region, (people and % share) 2010 Lo wer So uth Is., 300,346, 7% Upper So uth Is., 734,426, 17% Central, 473,942, 11% M id-Central, 541,322, 12% No rthland & Waitemata, 697,240, 16% A uckland, 451,821, 10% Co unties M anukau, 493,203, 11% Waikato & B ay o f P lenty, 677,887, 16% Page 23 of 36