VAD update: advice and action | AMA (WA)


Doctor's hand on patient's hand

VAD update: advice and action

Tuesday June 1, 2021

Dr Scott Blackwell, Chair, VAD Implementation Leadership Team

The role of the Implementation Leadership Team (ILT) on Voluntary Assisted Dying (VAD) has been clear from the outset. The debate on VAD has been well heard in the community and in Parliament and the legislation that has emerged has a requirement that implementation occurs within a specified time. The ILT has the role of advising the Director General of Health and his steering committee within the Health Department (DoH) on all aspects of implementing the legislation.

Membership of the ILT was selected to provide the broad range of expertise required to develop high-level advice on implementation of VAD. The project team within the DoH is providing high-level support so that we have been able to capitalise on the expertise in the room (or as is often the case these days, on the screen).

The ILT and the project team worked assiduously over the nine months leading up to Christmas, bringing together a lot of intelligence from overseas and interstate to the various aspects of VAD. Working in eight work streams, the ILT then developed advice to ensure that the implementation in WA is appropriate to the legislation and to the specific characteristics of our State. Looking at each work stream gives a clearer view of the progress made.

The VAD Board now has a charter under which it will function, and its membership and secretariat are in the development stage. Clinical service guidelines and a service delivery framework have been developed. Participating practitioner eligibility requirements are in place and a model of validation in the development stage.

VAD substance protocols are agreed and a statewide pharmacy service is in development. A Care Navigator role has been defined and a statewide service model developed. This is a new role in Health in WA and is seen as essential to providing support to those who choose VAD as an option at the end of their life and those assisting them through the process.

The requirements of the mandatory Participating Practitioner Education and Training have been agreed and the training program is currently in development.

Community, Consumer, and Health Provider information has been developed and will soon be disseminated in a variety of forms.

A Voluntary Assisted Dying information management system (VAD-IMS) is currently under development. This will facilitate the process for clinicians who see people who choose VAD, as well as facilitate the operations of the Board.

A lot of work has been done on data, reporting and research. The various forms required in the VAD process are in place and the VAD-IMS will provide for an efficient use of these forms, as well as for efficient development of the reporting and monitoring requirements of the Board.

The ILT has commenced this year with the realisation that from here on, its work will be more operational and that this is really for others to take on – there is a challenge in that. There is much to do in achieving this transition into a fully operational process by implementation on 1 July 2021.

The members of the ILT have at all times maintained the focus that this legislation is about a Western Australian person who we know will die soon and who we know is suffering in a manner unacceptable to themselves and who chooses VAD as an option for their end-of-life care. The ILT has at all times faced the challenge of VAD being accessible and at the same time safe.

VAD is not a new service in Western Australia; it is a new option for people at the end of their life. The numbers involved will be quite small and it does not change the landscape of end-of-life care in WA. It could however challenge each of us individually should a person under our care make a choice to access VAD. We should all be prepared for this.