Timely palliative care referrals in Gippsland

In Gippsland, 82% of Oesophagogastric (OG) and Pancreatic cancer patients were diagnosed with incurable disease in 2022–2023.

Yet, only 12% were referred to palliative care within three months of death, which is well below the 80% benchmark outlined in Optimal Care Pathways (OCPs). Similar gaps were noted in Advance Care Planning (ACP).

Informed by the 2024 OG Summit and earlier Pancreatic OC Summit recommendations, Gippsland Regional Integrated Cancer Service (GRICS) is supporting the pilot implementation of a region wide Care Plus Clinic for OG and pancreatic cancer patients. This pilot is led by Palliative Care Consultancy Gippsland (PCCG ) Nurse Practitioner Kelly Koschade and supported by GRICS Cancer Service Improvement Coordinator Caroline Lasry. This model of care uses agreed “trigger points” for systematic referral to palliative care when the patients cancer is deemed incurable.

The nurse-led model offers three specialist palliative care appointments alongside standard care and aides patients through psychosocial support, symptom management, ACP completion, supportive care screening and referrals and patient centred discussions regarding palliative care. It streamlines referrals to palliative care, introduces and integrates palliative care earlier in a patients treatment, and aims to improve patient quality of life.

The project’s outcomes are being measured at 6 and 12 months by referral rates, ACP uptake, service referrals, and focus groups with oncologists. This model aligns with the Victorian Cancer Plan and addresses significant deviations from the Optimal Care Pathways in a sustainable, patient-centred way.