Background
Regional patients in Victoria have an increased likelihood of presenting with metastatic OG cancer at time of diagnosis. The most recent OG and Pancreatic Optimal Care Summits identified timely referral to palliative care (PC) services in Gippsland are well below the target of 80%, with less than 15% of all patients with incurable OG or pancreatic cancer referred to PC three months prior to death. This data only considered admissions under a PC bed card; however, it has been estimated that as many as one in two PC episodes are provided outside the inpatient setting.
Aim
To corroborate local data with state-wide data sources in identifying timeliness of referral to local and regional PC services in Gippsland of incurable OG and pancreatic cancer patients; and develop an implementation plan to address identified barriers.
Results
Using the Gippsland Cancer Services Database, we identified that 82% of patients diagnosed in the Specialist Oncology clinics with OG or pancreatic cancer were incurable at diagnosis during 2022-23. Of those, only 42% of patients were referred to specialist PC services. Furthermore, only 12% of deceased patients within this dataset were referred to PC services 3 months or more prior to death.
Conclusion
Local data supports wider Victorian data which identifies an unacceptably low proportion of incurable OG and pancreatic cancer patients receive timely referrals to PC services. In response, through collaboration with the Palliative Care Consultancy Gippsland service, we plan to integrate a CarePlus clinic model in Gippsland for all incurable OG and pancreatic cancer patients. This model uses standardised referrals at pre-defined disease-specific points to automatically integrate PC into routine Oncological care through at least three consultations with the specialist palliative care team in Gippsland. Extending this, we will continue to investigate further barriers to referral within this incurable cancer group.