Specialist palliative care services

Specialist palliative care services are comprised of a multidisciplinary team with expertise in managing complex or refractory symptoms and supporting patients and families with psychosocial or spiritual distress, as well as providing a bereavement service.

Specialist palliative care services may operate from a variety of settings, including hospitals, palliative care units and community-based services. Members of the specialist palliative care team should help other healthcare professionals to understand how specialist services operate locally, and ensure members of the specialist team can be contacted easily.

Specialist palliative care services can provide advice and support on an as-needed basis, or assume full responsibility for the management of patients with complex and difficult problems. Referral to (or a phone discussion with) a member of a specialist palliative care service may be appropriate at any stage of patient care. Most specialist palliative care services have clearly defined admission policies, and some form of triage is often undertaken before admitting a patient to the service. Tools like SPICT can be used to aid decisions about referring a patient to specialist care.

Early involvement of a specialist palliative care service should be considered when:

• future need for palliative inpatient or home-based care at the end of life is anticipated
• symptom management is expected to be difficult (eg head and neck cancers)
• complex psychosocial or care issues exist
• the family or carers are feeling overwhelmed or distressed.

More urgent consultation should be considered when:

• symptoms are not well-managed
• a palliative care emergency is imminent (see Emergencies in palliative care).

Access to specialist palliative care services varies widely across Australia. To find a specialist palliative care service, see the Palliative Care Australia national service directory.