Improving Equity in Access to Palliative Care Communities

Improving Equity in Access to Palliative Care brings together diverse perspectives and experiences, including people with lived and living experiences, to make measurable improvement in access to palliative care with and for people experiencing homelessness or vulnerable housing.

Healthcare Excellence Canada and the Canadian Partnership Against Cancer are supporting nine communities in the first cohort of the program. The participating communities are in seven provinces, spanning urban, rural and remote settings.

Alt text: A map of Canada showing Vancouver Coastal Health/Providence Health Care in British Columbia; George Spady Society in Alberta; Medavie Health Services West-Moose Jaw in Saskatchewan; Winnipeg Regional Health Authority in Manitoba; NorWest Community Health Centres, The Second Mile Club of Toronto/Kensington Health and Kingston Community Health Centres in Ontario; Institut de soins palliatifs et de fin de vie in Quebec; and Eastern Health in Newfoundland and Labrador.

Participating communities and projects

The following teams have been accepted to participate in Improving Equity in Access to Palliative Care.

Eastern Health (Mount Pearl, Newfoundland and Labrador)

Eastern Health is the largest health authority in Newfoundland and Labrador, serving residents on the Avalon, Burin and Bonavista Peninsulas.

Through the Improving Equity in Access to Palliative Care program, Eastern Health aims to:

• complete a needs assessment for people experiencing homelessness or vulnerable housing who could benefit from palliative approaches to care
• develop and implement a clinical pathway to improve access to palliative care services
• offer education on palliative approaches to care for community partners.

Eastern Health will work with the Downtown Health Collaborative, the Gathering Place, Stella’s Circle, Choices for Youth, Centre of Hope and other community partners.

George Spady Society (Edmonton, Alberta)

The George Spady Society provides a continuum of support services to people with complex life circumstances associated with substance-related concurrent disorders and homelessness, empowering them to improve their lives through client-centred, evidence-informed best practices.

Through the Improving Equity in Access to Palliative Care program, the George Spady Society aims to:

• provide palliative supports, home care, transitional support from acute to community care
• consult with healthcare providers and provide hospice support and information to people experiencing homelessness or vulnerable housing.

The George Spady Society is partnering with the Palliative Care Outreach and Advocacy Team (PCOAT) at the Indigenous Wellness Clinic and the Calgary Allied Mobile Palliative Program (CAMPP).

Institut de soins palliatifs et de fin de vie Michel-Sarrazin – Université Laval (Québec)

The Institut de soins palliatifs et de fin de vie Michel-Sarrazin – Université Laval contributes to the field of palliative and end-of-life care through its research and knowledge transfer activities.  

Through the Improving Equity in Access to Palliative Care program, the Institut de soins palliatifs et de fin de vie Michel-Sarrazin – Université Laval aims to forge ties between people who are homeless or at risk of homelessness, care providers, and community organizations in the Québec City region in order to adapt palliative and end-of-life care to the needs of homeless or precariously housed individuals.  

The Institut’s partners: Clinique SPOT; Direction du soutien à l’autonomie des personnes âgées, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale; Lauberivière; Centre d’hébergement autochtone de Québec; Direction de la qualité, de l’évaluation, de l’éthique et des affaires institutionnelles, CHU de Québec; Ministère de la Santé et des Services sociaux, Direction des soins infirmiers et responsable du dossier des soins palliatifs.

Medavie Health Services West - Moose Jaw (Moose Jaw, Saskatchewan)

Medavie Health Services West brings together four western emergency medical services (EMS) companies – MD Ambulance, Moose Jaw and District EMS, Guardian Ambulance, and Prairie EMS – into a single organization with regional expertise connected to national leadership in primary care.

Through the Improving Equity in Access to Palliative Care program,  Medavie Health Services West - Moose Jaw aims to provide medical supports and treatment, as well as referrals to appropriate resources, to people experiencing homelessness or vulnerable housing who have palliative care needs through their community paramedic program. 

Medavie Health Services West - Moose Jaw partnering with Square One Community Moose Jaw Inc., Thunder Creek Rehabilitation Association, Saskatchewan Health Authority and the Moose Jaw Age Friendly Committee.

NorWest Community Health Centres (Thunder Bay, Ontario)

NorWest Community Health Centres provides primary healthcare and social services in the Thunder Bay community and surrounding District.

Through the Improving Equity in Access to Palliative Care program, NorWest Community Health Centres aims to:

• improve access to care through an outreach worker dedicated to vulnerably housed palliative care clients
• increase knowledge about palliative care among healthcare providers and people experiencing homelessness
• inform future programming though community engagement sessions and then build capacity to address identified needs in the community

NorWest Community Health Centres is partnering with Hospice Northwest, St. Joseph’s Group Northwest Regional Palliative Care Program, Thunder Bay Palliative Care Associates, and The Centre for Education and Research on Acting and Health (CERAH).

Kingston Community Health Centres (Kingston, Ontario)

Kingston Community Health Centres is a dynamic provider of integrated services that empower people and build communities. They strive to create inclusive, resilient and healthy communities.

Through the Improving Equity in Access to Palliative Care program, Kingston Community Health Centres aims to better understand the unique needs of people experiencing homelessness or vulnerable housing and requiring palliative care services, and ensure that they are connected to specialist palliative care services in a seamless and equitable manner.

Kingston Community Health Centres is partnering with Queen’s University Palliative Medicine Program, Home-Based Housing and Queen’s University.

Second Mile Club of Toronto/Kensington Health (Toronto, Ontario)

The Second Mile Club of Toronto/Kensington Health supports older adults and people living with disabilities in the community. They offer safe, recreational spaces and in-home services for older adults and adults living with disabilities. They also offer crisis intervention, home-making, senior active living centers, community day hospice and a caregiver support program.

The Second Mile Club of Toronto/Kensington Health is funded by the Ontario Ministry of Health, the Ontario Senior Secretariat, and the City of Toronto.

Through the Improving Equity in Access to Palliative Care program, the Second Mile Club of Toronto/Kensington Health aims to provide support, advocacy and case management to individuals who are living with life-limiting illness while experiencing homelessness through a peer worker who will work alongside a health navigator.  

The Second Mile Club of Toronto/Kensington Health is partnering with the PEACH – Palliative Education and Care for the Homeless program, which is a program through the Inner City Health Associates and The Neighborhood Group to ensure that the Peer Worker Initiative is collaborative and best serves the community we care for.

Related resources:

• Palliative Education and Care for the Homeless (PEACH): A Model of Outreach Palliative Care for Structurally Vulnerable Populations (Healthcare Quarterly, April 2023): This article describes how PEACH’s unique model, critical community partnerships and research have been necessary for it to become a leader in community-based palliative care for structurally vulnerable people.

Vancouver Coastal Health/Providence Health Care (Vancouver, British Columbia)

Vancouver Coastal Health and Providence Health Care are responsible for the delivery of community, hospital and long-term care services to people in communities including Richmond, Vancouver, the North Shore, Sunshine Coast, Sea to Sky corridor, Powell River, Bella Bella and Bella Coola, and provide specialized care and services for people throughout the province.

Vancouver Coastal Health and Providence Health Care are the provincial hub for healthcare education and research, and together provide services to the Vancouver Downtown Eastside of Vancouver where a large community of people experience homelessness and/or precarious housing, and multiple other structural vulnerabilities.

Through the Improving Equity in Access to Palliative Care program, Vancouver Coastal Health and Providence Health Care aim to:

• better understand the care planning preferences of patients who are experiencing homelessness or other structural vulnerabilities and living with a serious illness
• develop, implement and evaluate patient-informed best practice guidance for serious illness care planning conversations
• address barriers and improve communication and collaboration between teams that support patients in the Downtown Eastside community of Vancouver, including community care and acute care teams and other service providers

Vancouver Coastal Health and Providence Health Care partnerships for this project include the Peer Operations/Overdose Emergency Response Team, Vancouver Coastal Health Indigenous Health, Vancouver Coastal Health Regional Mental Health/Substance Use, First Nations Health Authority, and BC Centre for Substance Use.

Winnipeg Regional Health Authority (Winnipeg, Manitoba)

The Winnipeg Regional Health Authority provides healthcare services to residents of the city of Winnipeg, as well as the northern community of Churchill and the rural municipalities of East and West St. Paul.

Through the Improving Equity in Access to Palliative Care program, the Winnipeg Regional Health Authority aims to establish and implement a strategic plan for providing palliative approaches to care for people experiencing homelessness or vulnerable housing within their jurisdiction.

Winnipeg Regional Health Authority is partnering with George and Fay Yee Centre for Health Innovation and Shared Health to collaboratively work with existing partners who support those experiencing homelessness within the Winnipeg Health Region.  Additional stakeholders and participating agencies will be added through an iterative, targeted engagement strategy as part of this collaborative.