Background Approximately 70% of deaths in Australia are due to non-malignant illnesses, however, only 25% of these patients receive palliative care input according to Palliative Care Outcomes Collaborative data. This highlights a significant gap in palliative care service provision in Australia. In 2022, funding was allocated to the South-Eastern Sydney Local Health District to address this gap through enhancement of community-facing palliative care services. The model of care that emerged through consultation was a multidisciplinary hospital clinic targeting a patient cohort with chronic non-malignant diseases and an expected prognosis of 12 –24 months.

Objectives This study presents a description of the model of care, demographics and clinical profile of the patient cohort and early outcomes in the first 12 months of operation of the St. George Hospital Supportive Care Service (SCS).

Methods A prospective observational study was conducted using patient data obtained from the SCS over a one-year period. We measured symptom burden and quality of life with the IPOS and the EQ-5D-5L. Descriptive statistics were used to analyse demographic and clinical data. IPOS and EQ-5D-5L data completed at the patient’s initial appointment and at follow up were compared for improvement, decline or stability of symptom burden and quality of life.

Results A total of 74 patients were reviewed by the St. George Supportive Care Service between April 2023 and April 2024. The mean age of the patient cohort was 79.4 years and there was an equal split between male (n=37) and female (n=37). Majority of patients had a primary diagnosis of cardiac failure (39%), followed by end-stage respiratory disease (28%), neurodegenerative disease (16%) and liver failure (10%), renal failure (4%) and other illnesses (3%).

The Palliative Medicine Specialist had advanced care planning discussions with 100% of patients. At the time of writing, 43 (58%) patients had completed an Advance Care Directive or Advanced Care Plan. All patients had initial IPOS and EQ-5D-5L surveys completed, however only 12 patients (16%) completed follow-up surveys. Outcomes from the IPOS demonstrate that symptom burden either improved or remained stable for 85% of patients who completed an initial and follow up IPOS survey. For 82% of patients who completed an initial and follow up EQ-5D-5L survey, their symptoms either remained stable or there was improvement in their quality of life.

Of the patients seen by the SCS, 21 (28%) died during the 12-month period. The mean survival for these patients from referral to the service was 2.7 months. Of those patients, 10 (48%) died in a palliative care unit (PCU); 8 (38%) died at home; and only three (14%) died in an acute hospital setting.

Discussion Our study describes a new model of care for palliative care service provision targeted at patients with chronic, non-malignant illnesses who have an estimated prognosis of 12–24 months. The results so far demonstrate that early intervention by a multidisciplinary palliative care team leads to high rates of advanced care planning discussion and documentation, positive impact on patients’ symptom burden and quality of life and reduces likelihood of death in an acute hospital setting.