After Hours Palliative Care Provision in Rural and Urban Victoria, Australia

Objective: This paper reports the preliminary findings of a project exploring after hours palliative care service provision in three regions of Victoria, Australia. The outcomes of this phase will inform the subsequent quantitative survey in the next phase. Design: Qualitative: thematic analysis of transcribed semi-structured interviews. Setting: Of the three participating regions, one is classed as urban (highly accessible), one both urban and rural areas (45% highly accessible, 65% accessible), while the third is entirely rural (19% accessible, 65% moderately accessible, 16% not classified). Participants: Thirty-eight interviews were completed with general practitioners (12), nurses (12), managers (5), terminally ill people and their carers interviewed together (9). Participants were recruited from across the three participating regions through the relevant Divisions of General Practice and the participating palliative care services. Result: Some examples of satisfaction with services were indicated, however, gaps in the provision of after hours palliative care services, such as training, remuneration and availability of general practitioners, care planning that includes after hours care, interdisciplinary team communication issues, staff safety and after hours telephone support and information for families, were all identified by stakeholders. These results will be used to inform the development of a quantitative study to explore these issues with a larger number of participants. Conclusion: Further research is needed to explore these gaps and to test alternative or modified models of after hours care. Awareness of these problems can be used to inform policy development for after hours service arrangements.