A world class health system ensures best practices are implemented across the cancer care continuum, from prevention and diagnosis to survivorship and, where necessary, palliative, and end-of-life care. With cancer being the leading cause of death in Australia, there is need for a nationally consistent and integrated approach to palliative cancer care with sustainable longer-term investment, allowing consumers to face end-of-life with dignity. Despite growing awareness of the value of quality palliative and end-of-life care, there is limited coordination and investment into end-of-life care, and a shortage of specialist services. Referral and access to palliative care services is also inconsistent across population groups.

While palliative care should be introduced early upon diagnosis of life-threatening illness to ensure quality of life and prevention or relief of suffering, end-of-life care focuses on the final months before an expected death.[136]

This action recommends integrating care models and implementing evidence-based best practices to provide consumers including their carers and families with high-quality and timely end-of-life care that is nationally coordinated, consistent and in line with a world class health system.

This 2-year action may include:

• improving national coordination and implementing national standards and protocols for safe, high-quality palliative care
• considering alternative funding mechanisms for palliative care in line with increasing demand for palliative care as Australia’s population ages
• integrating specialist palliative care, pain management and psychological services into advanced multidisciplinary models of care for consumers including their carers and families
• increasing access to psychological services for carers and family members engaging with palliative care, advance care planning, end-of-life care and VAD
• developing alternative end-of-life care options, such as dying at home, in aged-care facilities or in hospital, or VAD, and ensuring consumers, carers and family members are aware of these options
• implementing personalised approaches to palliative care, advance care planning and end-of-life care, including coordinating with communities and tailoring care to the needs of priority population groups, as well as considerations of intersectionality
• improving access to palliative care, advance care planning and end-of-life care information and resources, including VAD, earlier in the cancer care journey
• establishing transparent systems to measure, review and analyse palliative care performance and pilot innovative models of palliative care
• supporting the healthcare workforce with skills and resources on broaching difficult conversations about palliative care, advance care planning, end-of-life care and VAD with consumers including their carers and families, enabling an earlier introduction to palliative care.

Implementation of this action should take into consideration the heightened experience of stigmatisation and taboo surrounding palliative care, which may act as a barrier to early access and uptake.

This action is dependent on the availability of a robust outcomes-focused evidence base, as laid out in Action 4.2.1 Developing an agreed national cancer data framework to improve accessibility, consistency and comprehensiveness of integrated data assets, and Action 4.2.2 Ensuring targeted and innovative research investment into areas of unmet and emerging need; and improve clinical trial design and equitable access. Implementation of this action will also align with the Palliative Care Australia Roadmap 2022–2027[137] and the National Palliative Care Strategy 2018.[138]