Innovation not isolation: regional palliative care responds to local need

  • Little Haven Palliative Care Market Place with outside musical performers

Little Haven Palliative Care Market Place

Dr John Rosenberg RN PhD, Senior Lecturer (Nursing), University of the Sunshine Coast QLD
Sue Manton OAM RN, CEO Little Haven Palliative Care, Gympie QLD
Kelly King RN, Clinical Nurse Little Haven Palliative Care, Gympie QLD

Providing community palliative care in a regional area is challenging. Providing 24hour support 365 days a year by scheduled and ad hoc home visits, even more so.

Chronic under-resourcing and physical distances to specialist care demands a local response when centralised healthcare systems are unable to deliver accessible care. While many regional Australian towns simply go without community palliative care services, in Gympie QLD a unique service has a longstanding presence in the town. Little Haven Palliative Care emerged 40 years ago when a local pioneer saw a need for palliative care and responded, giving rise to a unique model of care that blends healthcare provision with a deeply embedded place in the community.

There are several inpatient hospices found in regional Australia, where the local community has raised funds to establish the building for patient care. But providing specialist community based palliative care to people living, dying, caregiving and grieving at home is uncommon.

A recent evaluation by the University of the Sunshine Coast of Little Haven’s model of care shows Little Haven possesses all the structural elements found in optimal models of community palliative care services. Despite its relative isolation and history of inconsistent government funding, Little Haven provides a holistic, person-centred, multidisciplinary service, delivering specialist palliative care and ongoing bereavement support.

Uncommonly in this sector, it accepts all referrals regardless of how early in the illness trajectory the person is; it provides these services without charge to its users. It has strong, established links to local General Practitioners and pharmacists, and leads case-management with other service providers. Little Haven is flexible in its capacity to meet patients’ needs on a day-to-day and overarching basis, and in its support of patients’ preferences for care at home and, where possible, death at home.

Community-based models of care like this bring measurable cost savings to the healthcare system through the provision of palliative care at home versus hospital. This cost benefit, however, is not typically passed on to community-based service providers, who continue to be underfunded by government and rely heavily on fundraising.

It’s the way Little Haven is embedded in the Gympie community that is truly innovative, offering an approach other regional centres might consider. This integration goes beyond being ‘located in’ and ‘for’ the town and surrounding districts. This model of care demonstrates a service ‘from’ and ‘of’ the community, built from the grassroots in response to local need. After decades of operation, it is situated deeply within its community and upholds its responsibility to that community. It recruits a stable cohort of dedicated volunteers and clinicians. And the sense of mutual accountability is palpable.

Little Haven is viewed by locals as ‘their’ service which they support financially, voluntarily and publicly. In turn, Little Haven personnel express their sense of accountability to the communities they support; as one staff member put it: “I think our responsiveness comes from that community connection. We feel a responsibility to our community, because we’re part of the community…. When I work for Little Haven, I think ‘what does the community expect of us?’ and they don’t expect us to put someone off. If somebody reaches out to us and wants our support, then we give them our support”.  This might be why it is known for going ‘above and beyond’ what might otherwise be provided – more than just a service, it is a partner in the journeys of living, dying and grieving that are experienced in this community.



Comment Count

Submitted by Sue Manton (not verified) on Sat, 05/04/2024 - 07:22


Thank you for shining the spotlight on our communities model of community based palliative care. A model that removes all barriers to accessing care in the right place at the right time for those at the hardest of times.
We at Little Haven are always happy to mentor other regions to develop their own comprehensive support services to address the end of life care needs in their community.

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