How is the specialist-primary palliative care model functioning for cancer patients in the current New Zealand health system?

AIM: Patient barriers to accessing hospice and palliative care (PC) have been well studied. Important, yet less investigated, is how cancer patients whose hospice referrals were not accepted are being cared for. This article aims to understand the referral process from PC providers' perspectives and the implications of the current palliative system for patients, families and health professionals. METHODS: We conducted interviews with 28 healthcare professionals via Zoom. Participants worked in specialist and primary PC settings, such as hospices and aged residential care, and were based in seven Aotearoa New Zealand regions. We thematically analysed the interview transcripts. RESULTS: We identified four themes: the state of the PC system; communication issues; unmet needs and inequities; and managing care within the current system. CONCLUSION: The limited funding for PC and other health services is resulting in a decrease in PC services. The specialist-primary model of end-of-life supportive care in New Zealand is undermined by under-funding. The implications for cancer patients, their families/whānau and their healthcare professionals are moves towards a more biomedical model of PC, a reduction in training and unsustainable workarounds to manage care within the under-resourced system. Considering the ageing population, urgent action is needed.