Quality Practice Series #10 (November 2024)

In this edition:

• Feedback to the Board
• Updated Prescription and Administration Information
• Statewide Pharmacy Service on-call service
• Referrals for Determination
• Administration Decisions and Prescriptions
• Monitoring patient episodes in VAD-IMS
• VAD-IMS reminders

Message from the Voluntary Assisted Dying Board Chair

Voluntary Assisted Dying (VAD) has been operational in WA for over three years and the Board is pleased to see many of our original practitioners maintaining their registration as VAD practitioners by completing the training renewal module. We welcome the new practitioners joining the ranks to support the increasing number of patients seeking to access VAD.

The Board is currently finalising the 2023-2024 Annual Report to be presented to the Minister for Health with recommendations for improvements to the voluntary assisted dying process. The Annual Report will be available online after tabling in Parliament and a link will be included in the next Quality Practice Series. 

The Secretariat Unit has recently welcomed some new and returning faces to the team. Royce Ng joins us from the Mental Health Commission, Kelly Guest from St John's Ambulance and we welcome Kat Hornsey back from parental leave. The Secretariat Unit are available to assist practitioners, Statewide service providers and HSP Coordinators with any questions about VAD or issues with VAD-IMS.

Dr Scott Blackwell
Chair - Voluntary Assisted Dying Board

Feedback to the Board

The Board receives Personal Reflections throughout the year from people who have been touched by the voluntary assisted dying process, including patients, family members, friends, practitioners and service providers. While many of those reflections are positive and express gratitude for the end of life choices available to West Australians and for the compassionate and sensitive work of our VAD providers, the reflections also provide the Board with valuable insight into the barriers and problems that might be experienced by patients and families in accessing VAD.

These reflections help the Board to identify common themes, understand what is working well and identify areas for improvement, which can be used to raise issues with relevant parties, including the Minister for Health and the WA Health Director General, and inform the recommendations made by the Board in its Annual Report each year.

The Board welcomes the submission of personal reflections from your patients, their friends and families and yourselves to assist us in monitoring the operation of voluntary assisted dying in WA. The Personal Reflection form can be found here and can be emailed to the VAD Board Secretariat Unit (VADBoard@health.wa.gov.au).

Updated Prescription and Administration Information

The Voluntary Assisted Dying – Prescription and Administration Information outlines the process required to prescribe, receive and administer voluntary assisted dying substances. The Prescription and Administration Information pack has been updated in line with the latest developments and includes updated guidance for practitioners in delivering end of life care.

Over the next month, the End of Life Care Program Team will be sending out the new version of the Voluntary Assisted Dying – Prescription and Administration Information pack to VAD practitioners through express post.

Practitioners have been contacted by email but are reminded to keep their personal details, especially their mailing preferences, up to date on VAD-IMS.

For further information, please email VADApprovedTraining@health.wa.gov.au.

Statewide Pharmacy Service on-call service

Voluntary Assisted Dying Statewide Pharmacy Service (SWPS) are now offering an on-call service.

Phone: 6383 3088

Please call for information regarding VAD administration, VAD substance destruction information or to organise supply. 

Face to face education regarding VAD substances is available by the SWPS, please contact on the above number to organise.

Referrals for Determination

The Voluntary Assisted Dying Act 2019 (WA) (the Act) and WA Voluntary Assisted Dying Guidelines provide that if a coordinating or consulting practitioner is unable to determine the patient's diagnosis or prognosis (to the extent that it would be acceptable to the majority of their peers) or is unable to determine whether the patient has decision-making capacity in relation to voluntary assisted dying, they must refer the patient to a registered health practitioner with appropriate skills and training to provide a determination in relation to the matter.

In line with standard practice, the coordinating or consulting practitioner should explain the reason for the referral to the patient. The outcome of the determination should be provided as soon as practicable and copies of any reports received must be included in the First Assessment or Consulting Assessment Report Form at Appendix A. A proforma example of the referral can be found in the guidelines at Appendix F and linked here.

Administration Decisions and Prescriptions 

Pursuant to the Act, the making of an administration decision and issuing of a prescription must occur in a specific order. As the Administration Decision and Prescription are submitted as a combined form, this can sometimes lead to sequencing compliance issues for practitioners. If the administration decision is for self-administration, a Contact Person Appointment form will also need to be submitted in the correct order. 

For clarification of the process, activities should occur in the following order:

1. Administration Decision is made
2. If the decision is for self-administration, the Coordinating Practitioner should receive the Contact Person Appointment form and submit to the Board
3. Prescription is issued
4. Administration Decision and Prescription Form, and Contact Person Appointment Form (if required and not already submitted) are submitted to the Board.

VAD-IMS will not allow the submission of an Administration Decision and Prescription Form for a self-administration decision without a Contact Person Appointment Form having been submitted.

It is important to note that the prescription should not be issued before the Administration Decision is made or, in the case of a self-administration decision, before the Contact Person Appointment Form has been received by you, even if you are aware that the Contact Person Appointment Form has been completed by the patient and Contact Person.

Monitoring patient episodes in VAD-IMS

The Board has a function under the Act to monitor operations of Voluntary Assisted Dying. The Secretariat Unit undertakes real time monitoring of submissions in VAD-IMS to ensure compliance with the Act and good data health.

From July 2024 the Board implemented improved functionality to support the Secretariat Unit in undertaking this work. As a result, practitioners may be contacted by the Secretariat Unit to confirm the accuracy of information in VAD-IMS.

If you are contacted and have concerns, please reach out to the Secretariat Unit at VADBoard@health.wa.gov.au who are happy to assist.

VAD-IMS reminders

The Secretariat Unit continues to monitor and support practitioners with submitting the required notifications to the Board through VAD-IMS. Some common issues to look out for include:

• If you are planning a holiday, please remember to consider options for any patients who may require further voluntary assisted dying steps to be completed while you are away. This might include transferring roles before you leave or ensuring you have access to VAD-IMS and the ability to submit approved forms while away. It might also be advisable to take some blank forms with you, which can be completed and faxed or emailed to us.
• If you, as a Coordinating Practitioner, are advised or become aware of your patient's death, remember to submit a Notification of Death - Coordinating/Administering Practitioner Form in VAD-IMS to advise the Board of the patient's death and allow the episode to be closed.