National Consensus Statement: Essential elements for safe and high-quality end-of-life care
The Commission has developed the National Consensus Statement: Essential elements for safe high-quality end-of-life care which describes the key clinical and organisational requirements for delivering excellent end-of-life care.
Overview
The National Consensus Statement: Essential elements for safe high-quality end-of-life care describes a best practice approach to caring for people who are at the end of their life.
2023Publication, report or update
The Consensus Statement applies to all services where health care is provided to people approaching the end of their life, including:
- Hospitals
- Hospices
- Residential aged care facilities
- Home settings.
There are nine guiding principles that define safe and high‑quality end‑of‑life care. These are followed by 10 essential elements that outline the key actions that should be applied by healthcare services providing end‑of‑life care.
Guiding principles
Safe and high‑quality end‑of‑life care should:
| 1—Be person‑centred and include family and carers | People have the right to direct their own care, whenever possible. Families and carers should be involved, in accordance with the person’s expressed wishes and/or legislation. |
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| 2—Align with values, needs and wishes | End‑of‑life care should consider a person’s expressed wishes regarding the circumstances, environment and place in which they wish to die. Their needs, goals and wishes for end‑of‑life care may change over time. |
| 3—Provide people with information they can understand | People should be provided with health information that they can understand and be supported to make decisions at the end of their life. If a person lacks capacity to participate in decision‑making about their care, a substitute decision‑maker should make decisions according to their best interpretation of the preferences of the person, but only after options for supported decision‑making have been exhausted. |
| 4—Consider cultural, spiritual and psychosocial needs | Meeting the cultural, spiritual and psychosocial needs of people and their families and carers is as important as meeting their physical needs. This may include considerations such as beliefs and practices around the end of a person’s life and dying, and the time it may take to shape practices and processes accordingly. |
| 5—Include qualified, skilled and experienced multidisciplinary care | Effective communication, collaboration and teamwork that ensures continuity and coordination between teams, within and between settings, during transitions, and across multiple episodes of care is required. |
| 6—Ensure the right to refuse medical treatment | Decisions regarding treatment may be made in advance and remain valid unless the person or substitute decision‑maker, family or carers state otherwise. |
| 7—Not be burdensome or harmful | It is unethical to provide burdensome investigations, treatments and transfers that can be of no benefit and harmful to people. |
| 8—Not offer unreasonable hope | Unless required by law, clinicians are not obliged to initiate or continue treatments that will not offer a reasonable hope of benefit or improve a person’s quality of life. |
| 9—Continue after a person has died | Care of a deceased person, and bereavement care for families and carers, extends beyond the death of the person. |
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2023Fact sheet or brochureThe National Consensus Statement: Essential elements for safe and high‑quality end‑of‑life care provides healthcare services with a best practice approach to caring for people who are approaching the end of their life. There are nine guiding principles that define safe and high‑quality end‑of‑life care.
The Consensus Statement has been developed for:
- Healthcare workers who provide health care to people approaching the end of their life
- Healthcare service executives and managers responsible for developing, implementing and reviewing systems for delivering end‑of‑life care
- Clinical education and training providers, including universities and professional colleges
- Health professional registration, regulation and accreditation agencies
- Planners, program managers and policy makers who are responsible for developing state or territory policies, or other strategic programs delivering end‑of‑life care.
Background reading
The Commission engaged Flinders University’s Research Centre for Palliative Care, Death and Dying to undertake a rapid review of the literature to provide an update of the current evidence base that could inform a revision of the National Consensus Statement: Essential elements for safe, high-quality end-of-life care.
This literature review provides an update of the evidence to support quality and safety in end-of-life care in health service organisations.
This literature review provides information about quality and safety in end-of-life care beyond hospitals with a particular focus on Australians living in residential aged care or receiving aged care services in the community. There is also a supplement relating to care during the pandemic.
These literature reviews informed updates to the Consensus Statement published in 2023.
More information
Please email AdviceCentre@safetyandquality.gov.au if you require further information about end-of-life care.