In Australia, there has been an effort from the government over the past decade to improve equity and inclusion in palliative care. Policy context supportive of equity acts as a critical driver for enabling its translation into equity-oriented practice. However, the extent to which Australian palliative care policies incorporate equity, and their translation into actions and investments has not been extensively examined.

 

To explore policy approaches that supports equity and inclusion:

o   Ways in which equity is defined

o   The extent to which recommended strategies and actions are equity oriented

Methods 

We analysed 6 national and 22 jurisdictional palliative care policies, strategic plans and evaluation reports that are publicly available. The policy review was informed by an equity action framework. Inductive and deductive thematic analysis was used to identify key themes.

Findings
A shift of focus in considering equity in Australian palliative care policy was evident in documents.  Palliative care policies acknowledge and recognise the significant variation in access to palliative care services.  Strategies across jurisdictions have broadly focused on utilising a blended approach of ‘Targeted Universalism’ to improve palliative care services for all while identifying obstacles faced by specific underserved groups. Intersectoral collaboration is acknowledged explicitly or implicitly in policy documents.  However, collaboration was mainly seen as vertical collaboration (within health services) with minimal evidence of proposed or actual collaboration with sectors outside health. Compassionate communities’ approach to engage and empower communities is recognised in policy documents. However, the role of government in leading a public health approach to palliative care is not clear.

Achieving the goal of equity in palliative care for all is complex and multifaceted. It requires strong commitment and actions at policy and government level but also in clinical practice, workforce planning and capacity building, community engagement and research investment.