End of Life Choice Act implementation workforce surveys

As part of the implementation programme, three workforce surveys will be undertaken. 

  • In early February, the Ministry of Health issued the first survey to health practitioners about the implementation of the End of Life Choice Act 2019 (the Act).
  • In July, the Ministry of Health issued the second workforce survey about the Act, and the initial workforce training and guidance.

About the July survey

The July survey asked health professionals about their knowledge and understanding of the Act, and the first training module available as part of the implementation of the Act. 

The survey was optional and was open between 7-31 July 2021.  A total of 859 responses were received. 

In addition to the information provided in the surveys that informs implementation planning, inputs and feedback are also included through wide engagement with the health and disability sector, specific feedback opportunities as part of the development of detail of the assisted dying service, and via the training opportunities.  In addition, regular information updates are provided to support the implementation in the newsletter, and through the implementation information on the Ministry website.

The July survey sought feedback on the whether the respondent’s organisation is giving consideration to the implementation of assisted dying.  This survey did not seek information on the numbers of practitioners who anticipate providing assisted dying services when the Act comes into force.  A separate process is now under way to seek expressions of interest from medical practitioners, nurse practitioners, and psychiatrists who are willing to provide assisted dying services, and who would like to be included on the Support and Consultation for End of Life in New Zealand (SCENZ) group lists. 

Find out more: End of Life Choice Act statutory bodies and governance.

Below is a summary of the key findings from the second survey.

Key themes

One of the key themes from the February survey related to interest in training about the Act and health professional’s obligations under the Act.  In May, the first workforce online training module was made available to health professionals, along with a range of information sheets, and a regular health professionals’ implementation webinar series: End of Life Choice Act implementation resources.

Awareness of training opportunities

  • Just over half, or 52 percent of respondents, were aware of the training resources available to support health professionals in understanding the End of Life Choice Act, and the implementation of assisted dying in Aotearoa New Zealand
  • 23 percent of respondents had completed the training module about the Act.

Understanding of the Act

  • 52 percent of respondents indicated they had a good or very good understanding of the Act
  • 57 percent of respondents indicated they had a good or very good understanding of the eligibility criteria outlined in the Act
  • 35 percent said they have a good understanding of the specific obligations of health professionals as outlined in the Act, including the right of conscientious objection
  • 18 percent said they have a very good understanding of their obligations under the Act, including the right of conscientious objection.

Implementation and respondents

  • 24 percent of respondents believed their health sector organisation had some implementation planning under way or planning in place for when assisted dying becomes legally available
  • 47 percent of respondents identified as working in a public hospital
  • 23 percent of respondents identified as working in General Practice.

Next steps

Half the respondents indicated an interest in further education and training as part of the implementation of the Act, and 47 percent indicated an interest in how assisted dying services would be provided for or implemented by their employer.

Further resources are being made available to support health professionals and health and disability service providers prepare for when assisted dying becomes available in New Zealand on 7 November 2021.

All health professionals are encouraged to have an understanding of the End of Life Choice Act 2019 and their obligations under the Act.  Even if not directly providing assisted dying services, or parts of the service, health professionals are required to understand the Act, and what they are required to do under the Act should someone ask them for information about assisted dying.

The Ministry’s LearnOnline portal for health professionals has an assisted dying implementation learning section. This includes the online module: the End of Life Choice Act 2019 overview, which can be completed as an individual or as part of team meetings. 

The implementation resources also include the recordings of the regular implementation webinars, and information sheets to support health service providers’ implementation planning. New resources and training being added soon include:

  • An e-learning module about the assisted dying pathway
  • A guide to support conversations about assisted dying, and an accompanying e-learning module, developed by the Health and Quality Safety Commission
  • Guidance to support health and disability service providers to develop internal policies and procedures
  • Resources for health and disability service providers to use to educate the non-clinical and/or non-regulated workforce.

The Ministry of Health website is also being regularly updated with information and resources as part of the implementation. View the latest information sheets on the End of Life Choice Act implementation resources page.

About the February survey

The purpose of the survey in February was to gain an early understanding of workforce knowledge, understanding and attitudes of practitioners about the Act.

Learning about the number of practitioners who may choose to have a role in the assisted dying service, the settings they currently work in and any specific concerns they may have in relation to the Act inform the design, planning, and implementation of the system.

Health practitioners have a right to conscientiously object to providing assisted dying services. A response to the February survey was not a confirmation of a health professional’s choice to either participate in, or opt out of, the service.

The survey was completely optional.

The survey ran from 1 February to 28 February 2021 and a total of 1,980 responses were received.

Below is a high-level overview of some of the key findings of the survey. These figures represent the views of the health practitioners that opted into completing the survey.

Respondents and participation in principle

  • 47 percent of those who responded supported assisted dying in principle.
  • 53 percent of those who responded opposed assisted dying in principle.
  • Close to 30 percent of respondents indicated that they would possibly or definitely be willing to provide assisted dying services.

Respondents and their areas of interest

The survey asked respondents what areas of the Act, and the implementation, they would like more information on as implementation planning progresses. The top areas identified by respondents were:

  • how the process will work end to end
  • training and guidance
  • support available for clinicians
  • funding arrangements.

Key themes

The survey also included open-ended question and answer sections, so detailed responses, including feedback, queries and areas of concern, could be provided. 

The key themes that emerged from the survey will help inform the design of assisted dying services and the guidance for health practitioners, as the Ministry progresses the implementation of the Act.

Some of the key themes raised were:

Training for the sector

Respondents reiterated the importance of training and support for health practitioners, including requesting guidance on:

  • a health practitioner’s rights and responsibilities under the Act
  • assessing a patient’s eligibility
  • how practitioners would work together at each step of the eligibility process.

Recognising coercion 

Respondents raised the need for robust processes to ensure anyone with potential coercion/external pressures is excluded from accessing assisted dying.

Palliative care 

Respondents wanted to know how assisted dying fits with existing end of life services, such as palliative care, and noted the importance of equitable and accessible palliative care services

Medications

Respondents raised the need to ensure any medications used for assisted dying are safe and effective.

Support for whānau

Respondents would like more information about how a patient and their family/whānau will be supported in the process and how the process might involve, or have the support of, loved ones.

Level of involvement 

A number of respondents suggested that they would like to be involved in assisted dying through a support position, such as helping a patient and their family/whānau navigate the process, rather than being the lead medical or nurse practitioner in the process.

Next steps

There will be further opportunities for the health workforce to share their views during the implementation processes, including through two additional workforce surveys.

Health practitioners will be able to access resources that are appropriate for their level of involvement in providing services related to assisted dying. Please see the Learning for health professionals section on the End of Life Choice Act implementation resources page.

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