2022-23 Annual report

Providing palliative care, equitably

Palliative care improves quality of life for people and families facing cancer. It is an approach to care that manages people’s symptoms, addresses their emotional and psychological needs and supports them throughout the entire cancer journey.

High-quality palliative care can be delivered only if each member of the healthcare team has the skills to deliver the physical, psychosocial and spiritual support patients and families need as they navigate some of the most challenging events of their lives. Today, agreement about how to provide high-quality care varies, and most jurisdictions need more expert providers of this specialized care.

Some communities have less access than others to palliative care, and First Nations, Inuit and Métis communities are working to create culturally safe palliative care.

How partners are solving the challenge

To create equitable, high-quality palliative care with consistent standards across the country, the Partnership is investing on several fronts:

  • Working with partners to identify and support communities, such as people who are unhoused or vulnerably housed, who face unique challenges that can make it harder for them to get palliative care when they need it most.
  • Collaborating closely with First Nations, Inuit and Métis organizations and advisors to co-create resources that will improve access to culturally safe palliative care.
  • Expanding a framework that sets out the essential competencies healthcare providers need to deliver high-quality palliative care. This work is gaining real traction across Canada.

These solutions are in alignment with the federal Framework for palliative care in Canada and require a multidisciplinary approach, with collaboration among healthcare providers, patients, families and communities – and training and education for everyone involved in the palliative care journey.

What we achieved this year

Getting high-quality care to people who are unhoused

communities improving care for people experiencing homelessness or vulnerable housing

A new partnership between Healthcare Excellence Canada (HEC) and the Partnership is supporting 20 communities over four years to improve access to high-quality palliative care for people who are unhoused and vulnerably housed. The first 10 communities have been selected and projects are underway.

Participants receive funding, participate in learning webinars and workshops, coaching and peer-to-peer networking opportunities – all towards enabling them to implement and evaluate equitable, safe and high-quality palliative approaches to care. The Partnership and HEC expect the project to:

  • Improve unhoused and vulnerably housed people’s experiences of care
  • Help them access care and improve their health outcomes
  • Reduce the number of emergency department visits
  • Enable people to get palliative care in the environment they choose
  • Create meaningful partnerships with First Nations, Inuit and Métis communities, and people who have lived experience of homelessness or vulnerable housing

Communities involved in this journey will co-design, implement and evaluate the most effective solutions and approaches to palliative care.

From the outset, the Partnership and HEC have been working with health-equity advisors and clinical advisors to ensure best practices are used for building support and relationships in the communities.

Culturally safe care for First Nations, Inuit and Métis

The Partnership released a first-of-its kind resource called Beginning the journey into the spirit world: First Nations, Inuit and Métis approaches to palliative and end-of-life care in Canada, which identifies areas for action in palliative and end-of-life care.

The report is based on a series of discussions with First Nations, Inuit and Métis Elders and Knowledge Carriers, and community health professionals and researchers with expertise in palliative care. The Partnership engaged with these partners to identify the priorities, gaps, challenges and needs of communities for improving palliative care – and discuss the best ways to address them.

Beginning the journey into the spirit world bridges the history of Indigenous Peoples in Canada with a pathway and set of resources that empower Indigenous and non-Indigenous Peoples to develop community-based palliative and end-of-life care services. People using the report can adapt, expand on and refer to its strategies, programs and resources, all of which support Indigenous ways of caring for those who are ill or nearing the end of their lives.

Expanding Canada’s palliative care competency framework

The Canadian interdisciplinary palliative care competency framework is a curriculum guide and reference manual for six healthcare professions.

Released by the Partnership in collaboration with Health Canada, the BC Centre for Palliative Care and Pallium Canada in 2021, the framework is designed for jurisdictions that lack an explicit set of palliative care competencies. It also provides high-level guidance to provinces and territories that have built their own competency frameworks.

Already, the framework has:

  • Been endorsed by more than 20 national and provincial healthcare organizations and embedded in curricula, hiring practices and accreditation standards
  • Informed Accreditation Canada’s new long-term care standard
  • Been adopted and implemented by the Canadian Home Care Association throughout its workforce, including embedding the framework’s principles through formal training, a process that the Partnership is supporting

The framework was designed to be a living document, and this past year the Partnership invited other health disciplines to become involved. As one example, the Canadian Association for Spiritual Care has collaborated with the Partnership on an updated iteration of the framework, and others will follow. All will adopt the framework’s established process of engaging with partners and validating content.

An app in development with Pallium Canada, a leader in palliative care, will enable healthcare providers to do a palliative care competency self-assessment and then connect them with resources that meet their learning needs.