Ms Claire Marshall1, Dr Claudia Virdun1,2,3, Professor Jane Phillips1,2
1University Of Technology Sydney, Ultimo, Sydney, Australia, 2Queensland University of Technology, Kelvin Grove, Brisbane, Australia, 3Flinders University, Bedford Park, Adelaide, Australia
Biography:
Claire Marshall RN (BSc), MPallCare, PhD Candidate (UTS) is an experienced palliative care and cancer nurse with a background across acute, community, and rural settings. Her clinical career spans paediatrics and adult palliative care and oncology. In NSW, she advanced palliative care education at Sacred Heart Hospice through innovative training models. Since 2016, she has lectured in nursing education, focusing on professional practice and evidence-based care. Now based regionally in WA, Claire’s PhD explores models of palliative care for rural and remote populations to strengthen equitable end-of-life care.
Abstract:
Background:
Almost 45% of the world’s population resides in rural areas. Despite this, access to high quality palliative care is varied. Reforming and optimising rural palliative care is dependent upon effective policy.
Aim:
To map country- and jurisdiction- level policy against the elements of care required to optimise rural palliative care provision in high-income countries.
Design and Data Sources: An environmental scan of policies articulating actions specific to rural palliative care access and delivery, performed using a modified version of Khalil and colleague’s five-stage scoping review methodology. Grey literature was searched in November 2024 across Australia, Canada, Ireland, Japan, New Zealand, Norway, Sweden, United Kingdom, and the United States of America. Rural specific policy actions were mapped against the World Health Organization Innovative Care for Chronic Conditions Framework (ICCCF).
Results:
Of 3913 records screened, n=15 policies denoting 112 rural palliative care specific actions across 13 of 18 WHO ICCCF elements of care were identified. Over 90% of actions addressed macro-(n=52, 47%) or meso- level (n=49; 44%) elements, and two-thirds addressed five sub-categories: 1) Building workforce capacity; 2) Developing rural specific teams and positions; 3) Identifying, maintaining, and scaling new and existing rural palliative care models; 4) Identifying gaps in rural service provision and service planning; and 5) Increasing access to integrated rural palliative care.
Conclusions:
While there is a wide spread of actions across macro- and meso- level WHO ICCCF elements, there is limited focus on micro- level elements, and a lack of complementary actions within documents across the three layers of care. Country-level policies set the tone, and jurisdiction-level policies further target specific needs of rural communities within each area’s unique constraints. Optimising rural palliative care policy demands cross-sector participation and the involvement of rural consumers to co-design actions which reflect the unique rural environment and and bridge disparities.
15