Australia's Progress in Advance Care Planning: Challenges and Innovations
Institute member Dr Craig Sinclair has led work to address the key challenges in Advance Care Planning (ACP) in Australia.
ACP is a process that enables a person to plan for their future medical treatment and other care, for a time when they are not competent to make, or communicate, decisions for themselves. Whilst inherently an important consideration for older people, ACP is an important process for individuals and families across the life course.
Australia has made remarkable strides in ACP over the past two decades. States and territories have taken steps towards implementing ACP as part of routine care across the country, aligning with national accreditation standards, and a position statement taken by the Royal Australian College of General Practitioners. However one key challenge in ACP implementation is the lack of a consistent approach across Australia. Inconsistencies in legislation, terminology for ACP documents, and local policies between states and territories have hindered the development of a unified national approach to ACP, creating confusion and anxiety among health professionals and community members.
The COVID-19 pandemic significantly impacted the urgency, uptake, and use of ACP in Australia. As the country grappled with the virus, innovative measures were implemented, such as adopting telehealth and video-conferencing platforms for ACP discussions and relaxing legal requirements for document witnessing through legislative amendments. While some of these innovations have persisted beyond the pandemic, their effects on ACP implementation and patient rights protection need further examination.
Dr. Craig Sinclair, the lead author of the publication, stresses the importance of future research and practice to focus on ACP quality oversight and tailored programs for diverse communities.
“Advance Care Planning Australia has played a significant role in promoting agreed-upon best practices and providing online training modules for health professionals and the community. Further work is needed to enable cross-jurisdictional compatibility of ACP documents and consistent alignment with best-practice principles. The lessons learned from events like COVID-19 may help pave the way for a more cohesive approach to Advance Care Planning in the future,” says Dr Sinclair.
“Coordinating a unified national approach, which incorporates quality control, and enables tailoring for the specific needs of diverse communities are essential steps to ensure effective and accessible ACP for all Australians. "
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This publication was part of a special issue in the ZEFQ journal, which published updates from 29 countries around the world (including all inhabited continents) and was coordinated by the international society of Advance Care Planning (which includes researchers like Dr Sinclair). The special issue, released in conjunction with the recent ACPi 2023 conference in Singapore, is available open access for 1 year.
