Integrating community and clinical care to improve care at end of life across a rural area of south-east Queensland, Australia

The medicalisation of death and dying across the developed world has significantly diminished community’s role in care for those approaching the end of life. We say that palliative care is everyone’s business, but health services designed around systems have created a disconnection between the social and health needs of people who are dying. The consequences if this have been stark, for example, in Australia (when asked) 70% of people would like to die at home,1 yet less than 15% of people actually do.2 There is a strengthening movement around public health approaches to palliative care, which aim to integrate core public health values and strategies with clinical forms of palliative care to achieve authentic, ‘whole person care’. The West Moreton the Care at the End of Life Collaborative in Queensland, Australia was established in 2018 to improve outcomes and experiences for all people approaching the end of life in the West Moreton community. This is achieved through initiatives categorised by workforce education and development, community development and research and innovation. The Collaborative has embraced the public health approach by putting community at the centre of its consultation and codesign processes. The Collaborative model brings community and clinical representatives together to address the wicked problems associated with delivering quality care at the end of life across the region. This poster will specifically focus on the community development initiatives, and will demonstrate what we did, what we found and how we addressed the gaps. What we did: We conducted focus groups with community and people who have a lived experienced of care at the end of life (including people living with a life limiting illness). We also completed community, health and social care asset mapping to identify services and supports available within the community. What we found: Our consultation told us: •The West Moreton community is primed to be activated to care for people approaching the end of life. The community’s willingness to help and support others is evidenced through the abundance of community support assets and organisations. •There is a lack of understanding of death and dying in community, and this effects the community’s ability to respond when needed. •Whilst the structures are available in the West Moreton community, connecting the supports available to those that would benefit from them is lacking. The community identified the need for a ‘single source of truth’ for information and tailored specifically to the local area. How we addressed the gaps: In response to these findings the Collaborative codesigned several initiatives, including the development of the West Moreton Care Connect Website, a social media strategy, community education and the delivery of a community expo event. These initiatives have extended the Collaborative’s reach into community, enabling and fostering productive relationships which bode well for the future. References: 1.Productivity Commission. (2017). Introducing Competition and Informed User Choice into Human Services: Reforms to Human Services. (85). Canberra, Australia: Productivity Commission 2.ABS. (2021). Classifying place of death in Australia mortality statistics. Retrieved from https://www.abs.gov.au/statistics/research/classifying-place-death-australian-mortality-statistics#cite-window1