Table 5 Attributes of models for palliative care recommended by national policy documents from OECD countries available in English

Australia [23]

• Provide enhanced, coordinated support for carers, volunteers, communities of carers and carer respite

• Provide coordinated, flexible local care delivery for people at the end of life regardless of where they live and address any barriers

• Further improve the skill and confidence of the generalist workforce

• Enhance online palliative care support to ensure adequate numbers of skilled palliative care specialist providers across all disciplines

• Include end of life and palliative care competencies in all care worker training packages

• Enhance and legitimise the role of specialist consultancy services in providing direct clinical advice, education and training, advocacy for end of life issues and training places

• Record and track advance care planning within electronic health records

• Develop sustainable models of quality palliative care in the private sector

• Develop the role of the general practitioner in palliative care

• Undertake further research and ongoing monitoring of the relative cost of care

Canada [79]

• Availability and access to services

• Education for healthcare providers

• Ethical, cultural and spiritual considerations

• Public education and awareness

• Support for family, caregiver and significant others

Ireland [80]

• Provision of physical, psychological, social and spiritual support, with a mix of skills, delivered through a multi-professional, collaborative team approach

• Patients and families are supported and involved in management plans

• Patients are encouraged to express their preference about where they wish to be cared for and where they wish to die

• Carers and families are supported through the illness into bereavement

• The overall whole time equivalent (WTE) SPC nurse to bed ratio should not be less than 1:1

• In each day care centre, there should be a minimum of one WTE SPC nurse to every 7 daily attendees.

• There should be a minimum of one WTE specialist palliative care nurse per 150 beds in each acute general hospital

• There should be a minimum of one WTE specialist palliative care nurse in the community per 25,000 populations.

• There should be at least one WTE physiotherapist per 10 beds in the specialist palliative care inpatient unit, with a minimum of one physiotherapist in each unit

• There should be a minimum of one WTE community physiotherapist specialising in palliative care per 125,000 population. This post should be based in the specialist palliative care unit

• There should be at least one WTE occupational therapist per 10 beds in the specialist palliative care inpatient unit, with a minimum of one occupational therapist in each unit.

• There should be a minimum of one WTE community occupational therapist specialising in palliative care per 125,000 populations. This post should be based in the specialist palliative care unit

• There should be at least one WTE social worker employed per 10 beds in the specialist palliative care unit, with a minimum of one social worker in each unit

• There should be a minimum of one WTE community social worker specialising in palliative care per 125,000 population. This post should be based in the specialist palliative care unit

• Specialist palliative care services in all other settings, including general hospitals and the community, should be based in or have formal links with the specialist palliative care unit

• All specialist palliative care units should provide day care facilities for patients and carers

• Appropriate transport should be provided for patients to and from the centre

• There should be one point of entry to hospital services for palliative care patients, and subsequent referrals should be speedily organised

• In Accident and Emergency, the patient’s condition should be rapidly assessed, and the patient should be referred to the appropriate team without delay

• The specialist palliative care team in the community should be an inter-disciplinary consultant-led team

• The specialist palliative care team should be based in, and led by, the specialist palliative care unit in the area

• Specialist palliative care nurses should provide a seven-day service to patients in the community

• Arrangements should be made for the transport of patients receiving palliative care to different care settings, when required

• Bereavement support should begin early in the disease process, long before the death of the patient.

• Multidisciplinary assessment to ensure that all needs are identified early and individualised plan is established

• Allocate a care coordinator to each dying person

• Provide access to clinical care for each dying person (medical services, respite care, counselling, etc.)

New Zealand [81]

• Provide access to support services for dying patients and their families

• Ensure dying people and their families have access to essential palliative care (initial and specialized palliative acre)- at least one local palliative care service in each district health board

• Provide induction and ongoing training for volunteers in the community assisting in palliative care

• Provide flexible palliative care to meet varying and specific needs

• Inform the public about PCS.