2024-25 Annual report

Expanding access to palliative care

Improving equity in access to palliative care

Equity in palliative care remains a pan-Canadian priority, particularly for people facing homelessness or vulnerable housing. Healthcare Excellence Canada (HEC) and CPAC are supporting communities across Canada to ensure that more people – particularly those facing social, geographic or structural barriers – can access safe and high-quality palliative care.

As a result of the Improving Equity in Access to Palliative Care initiative, people experiencing homelessness or vulnerable housing in 23 communities across eight provinces now have improved access to high-quality, equity-oriented palliative care.

Medavie Health Services West – Moose Jaw, a collaborative in Saskatchewan, is already making a difference. Through its community paramedic program, the team is providing medical supports and treatment, as well as referrals to appropriate resources, to people experiencing homelessness or vulnerable housing who have palliative care needs. Early data from the implementation of a mobile wellness clinics in community-based settings suggests that 85 per cent of clients would not have sought care elsewhere if they had not attended the mobile clinic. In all, it is estimated that more than 1,000 people have accessed care through these mobile clinics, twice as many as originally planned, and the goal is to expand that reach in 2026.

Paramedics and palliative care

The evidence is in about CPAC and HEC’s Paramedics Providing Palliative Care initiative, which trained more than 7,500 paramedics and 200 healthcare providers across Canada to provide palliative care in patients’ homes. A recent study published in the Canadian Journal of Emergency Medicine confirmed the approach reduces stressful visits to the ER, and saves time and money:

• $2,773 saved per 9-1-1 call by treating patients at home
• 31 minutes saved per visit on average
• $4.60 return for every $1 invested
• 60 per cent of patients treated at home rather than in hospital (compared to the usual 10 per cent)
• 92 per cent of surveyed patients and families reported satisfaction with the care received

A companion paper published in Healthcare Management Forum describes how the model was scaled across Canada by leveraging early innovations and strong partnerships. It offers a roadmap for future healthcare innovations that aim to break down silos and expand across populations and geographies.

This work reflects CPAC’s commitment to compassionate, cost-effective models of care that honour patients’ preferences – especially the desire to receive care and remain at home at the end of life.

Expanding palliative care competency in home care

The Canadian Interdisciplinary Palliative Care Competency Framework, developed by CPAC and partners in 2021, is helping to build skills and confidence in delivering high-quality home-based palliative care across the country. The framework – originally created as a curriculum guide and reference tool for educators and providers – is now being embedded into training, orientation and human resource planning through a national initiative with the Canadian Home Care Association.

By the end of the project in March 2025, more than 1,000 staff from 13 home care organizations had participated. The results showed measurable improvements in communication, self-care and the fundamentals of a palliative approach. Ninety per cent of participants advanced key competencies and 94 per cent reported greater emotional awareness. Organizations reported significant gains in staff confidence and client communication, fostering a shift toward more emotionally intelligent, person-centred care.

Advancing culturally safe, equity-oriented palliative care

CPAC is supporting new approaches that increase the quality and accessibility of palliative care based on community-identified priorities. Five projects are underway to address systemic barriers by taking equity-oriented approaches, such as:

• Using virtual health strategies to support care delivery in Alberta
• Improving palliative care for patients with advanced cancers in Manitoba
• Developing equity-focused intake assessments and clinician training to better identify and address patients’ holistic needs in Alberta and British Columbia

In Manitoba, two First Nations, Inuit and Métis-led projects are advancing culturally safer, community-centred palliative care. One project is working with five Dakota Ojibway Health Services communities to co-develop models based on community priorities, including care close to home, cultural safety and reciprocal learning. Planned activities include cultural awareness and safety training events to strengthen trust and understanding between healthcare workers and community members.

The other is focused on developing palliative care models for Northern and remote communities, building on the success of a four-year, paramedics-led initiative in Interlake Eastern Regional Health Authority. Project activities include training community health workers on culturally appropriate approaches to palliative care and engaging with community partners, Knowledge Keepers and Elders to guide implementation.

Alongside this effort, projects guided by the Beginning the journey into the spirit world resource aim to expand access to palliative care within community settings, allowing individuals to receive care that reflects their values, cultures and connections to home. A partnership between SE Health and Maamwesying North Shore Community Health Services, called Supporting One’s Journey into the Spirit World, produced a 10-video series co-created with community Elders and youth to support caregivers with culturally relevant education. The videos are available in English, French and Ojibway, helping ensure that caregivers across diverse communities can access information in ways that are meaningful to them.

We’ve found a significant change in how they’re responding to patients and families. A shift in what is a palliative approach to care… It really is about supporting quality of life and how do we make sure that we’re looking at that throughout the whole illness trajectory.

– Staff, First Nations, Inuit and Métis Program, SE Health

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