Cloud looms over palliative nursing

Fewer patients are likely to get care from a trained nurse under changes to palliative care services in New South Wales.

“Privatising services previously delivered by the public sector has the potential to reduce nurse employment in palliative care.” –      Judith Kiejda
“Privatising services previously delivered by the public sector has the potential to reduce nurse employment in palliative care.”
– Judith Kiejda

The state government has announced it will deliver palliative care to more people at home – mainly by contracting out services to private providers.Health Minister Jillian Skinner said the $35 million program was aimed at giving more people the option of dying at home.

The centerpiece of the program is the provision of up to 2863 packages of home support by 2015/16 “designed to ensure safe and comfortable end of life care at home,” she said.

“While 70% of Australians say they want to die at home, only 16% do. Over half die in hospitals, 20% in hospices and 10% in nursing homes.”

The support packages for people dying at home are being delivered under three-year contracts for specific local health districts.

A consortium made up of Hammond Care, Sacred Heart and Calvary Health Care will service the local health districts of Central Coast, Northern Sydney, South Eastern Sydney, Western NSW, Murrumbidgee, Southern NSW and Far West.

South Western Sydney LHD in partnership with Silver Chain Group will cover the LHDs of South Western Sydney, Nepean Blue Mountains, Western Sydney, Sydney and Illawarra/Shoalhaven.

Silver Chain Group will care for patients in Hunter New England, Mid North Coast and Northern NSW.

Mrs Skinner described the $35 million as “new money” on top of the $86 million annual spending on palliative care.

However NSWNMA Assistant General Secretary Judith Kiejda says the program presents “significant professional and industrial concerns” for nurses.

“Privatising services is likely to downgrade the level of care available to patients,” Judith said. “Most of the private providers do not employ registered nurses for home care and their patients are more likely to be cared for by palliative care aides.

“Privatising services that previously were delivered by the public sector therefore has the potential to reduce nurse employment in palliative care.

“Ministry representatives were not able to tell us what level of clinical care would be provided in the different areas under the new arrangements.

“The ministry advised that while some service teams would be led by clinical nurse consultants, others would be headed by palliative care aides.

“This means palliative patients will be treated differently depending on which LHD they live in.

“The ministry was also unable to provide information on the training of the non-nursing workers who will be involved in the services.”

Mrs Skinner said that in addition to at-home care the $35 million program would pay for a “pop up model of care” to mobilise clinical expertise and support for a dying child as close to home as possible.

She said the program would also establish an after-hours telephone support service staffed by palliative care nurses.

Mrs Skinner said the Health Ministry would spend an additional $3 million to fund 30 extra clinical nurse specialists and clinical nurse educators in palliative care in 2013/14.