Overall, the number of people appraised as requiring palliative care using PRAC in 2021–22 was relatively similar to 2017–18, driven by large annual fluctuations over the preceding 5 years, as shown in Figure AC.3. In contrast, the number of people using PRAC not appraised as requiring palliative care generally increased slightly each year (2% increase overall between 2017–18 and 2021–22).
The number of new admissions to PRAC appraised as requiring palliative care also experienced some fluctuations over this period, but overall declined by 11% between 2017–18 and 2021–22. This rate of decline was steeper than for those not appraised as requiring palliative care (overall decline of 3.7% over this same period).
Between 2019–20 and 2020–21, there was a decline in the number of people and new admissions to PRAC for people assessed as requiring palliative care (by 3.4% and 5.0%, respectively), and a subsequent increase in the following 12 months (by 6.8% and 1.6%, respectively).
These patterns likely reflect the introduction and easing of public health measures introduced to manage the spread of the COVID-19 pandemic during 2020 and 2022. In particular, the various falls in new admissions and rises in exists coincided with lockdowns and the tightening and easing of restrictions in response to the waves of the COVID-19 and new strains of the coronavirus. For example, compared with corresponding months in 2018–19, the number of new admissions to PRAC for people assessed as requiring palliative care fell by 19% in May 2020, 25% in October 2020, 21% in October 2021 and 17% in January 2022 but increased by 20% in March 2022 – similar to the patterns observed for new admissions to PRAC for people not assessed as needing palliative care. Exits from PRAC for those appraised as requiring palliative care also followed a similar pattern – 28% higher in April 2020, 22% higher in May 2020, and 15–18% higher in September 2020, May 2021, September 2021, December 2021, and May 2022 (compared with corresponding months in 2018–19). This report did not explore the reasons for these PRAC exits (such as death or to another setting).
These fluctuations in new admissions and exists may reflect a number of factors that not related to the COVID-19 pandemic (see 2022 edition of this report for further details on the impacts of COVID pandemic). Further, ACFI reviews were undertaken from the Department of Health's offices since 2020 to minimise COVID19 transmission risks (DoH 2020).