Responding to concernsThe acute health service’s policies make it clear that:

  • the concerns of nurses and junior doctors are acknowledged and valued
  • the judgement of nursing staff that a patient’s death is imminent is acknowledged and respected
  • ensuring appropriate end of life care is as important as escalating care for a reversible condition
  • a patient in physical, psychosocial or spiritual distress needs rapid assistance from a skilled clinician
  • a second opinion from an independent senior clinician is to be sought if clarity is needed
  • when managing conflict, complex family dynamics or ethical dilemmas, help can be sought from a person skilled in mediation, the rights of the person, bioethics or the law.

A process for escalating concerns is in place.

Reasons for referral to the palliative care consultancy service include:

  • there are difficult symptoms
  • discussions about goals of care, between team members or with patients and their families, are becoming complex
  • bereavement risk is likely to be moderate or high. 

All public metropolitan health services have a hospital-based palliative care consultancy service except for Royal Victorian Eye and Ear Hospital and Royal Women’s Hospital.

Each rural region has a palliative care consultancy service to provide specialist consultation to acute health services, among others.