Continuous improvement of Voluntary Assisted Dying (Voluntary Assisted Dying Board Annual Report 2022-23)

Improvement activities are undertaken by all clinical and operational staff supporting voluntary assisted dying in South Australia.

Building community awareness and understanding

To promote awareness of and engagement with voluntary assisted dying in the community and understanding of the requirements of the Act, SA Health continues to engage with a range of people and organisations in South Australia.

Release of quarterly voluntary assisted dying reports

The release of two voluntary assisted dying quarterly reports on 7 June and 22 August 2023 provided the Board with an early opportunity to share feedback and learnings as well as keeping the community up to date regarding voluntary assisted dying activity in South Australia. Quarterly reporting will continue to be a key mechanism for building community awareness and understanding of voluntary assisted dying. To read the reports visit the VAD Review Board website.

Voluntary assisted dying communique

SA Health releases a regular voluntary assisted dying communique to health practitioners and the community to keep people informed of activities and changes in voluntary assisted dying. The communique is distributed to over 800 people. To join the mailing list email with the subject ‘Join the mailing list’.

Aboriginal and/or Torres Strait Islander Review Board member

To help establish and maintain equitable access to a culturally safe and appropriate voluntary assisted dying pathway, the Minister for Health and Wellbeing approved a process to appoint a new Aboriginal member to the Board. As a result an expression of interest process was conducted to identify a suitable candidate and an appointment process is underway.

Engagement with key stakeholders including Voluntary Assisted Dying SA (VADSA)

As the peak non-government representative body for voluntary assisted dying in South Australia, VADSA are an important and valued stakeholder. In addition to their involvement on the Voluntary Assisted Dying Implementation Taskforce, SA Health has continued to meet with regularly with VADSA since the commencement of voluntary assisted dying on 31 January 2023 to share learnings and explore opportunities for collaboration and community education. The Review Board thanks VADSA for their advocacy and efforts and looks forward to continuing the collaboration between SA Health and VADSA in the future.

Education, training, and support for medical practitioners

Establishment of a Voluntary Assisted Dying Community of Practice

The Commission on Excellence and Innovation in Health (CEIH) convenes a monthly Voluntary Assisted Dying Community of Practice in South Australia. The Voluntary Assisted Dying Community of Practice is a place where participating practitioners can:

  • share and reflect upon their experiences participating in voluntary assisted dying
  • provide practical and emotional support for each other
  • learn from each other to advance best practice in voluntary assisted dying care.
  • collectively problem solve to manage complex aspects of voluntary assisted dying.

“Professionally there is real equality experienced across all medical practitioners. GPs and specialists all come together as a united group working in this new and challenging space.”

“The extended community of practice group further reinforces that you are part of a multi-disciplinary community offering unique perspectives and valuable insights.”

Voluntary Assisted Dying HealthPathways for GPs

HealthPathways SA has developed a new pathway to assist health professionals to understand their potential role in voluntary assisted dying as well as their legal rights and obligations in relation to voluntary assisted dying. This new pathway is being promoted to General Practitioners through the Country and Adelaide Primary Health Networks.

Improving systems and processes in response to practice

The use of telehealth in voluntary assisted dying

Telehealth plays an important role in facilitating equity of access to health services, in particular for people residing in regional South Australia.

Currently the Commonwealth Criminal Code Act 1995 (Cth) prohibits the use of telehealth and other carriage services to discuss or send ‘suicide-related’ material. This has been interpreted to impact on discussions relating to voluntary assisted dying, including the provision of medication and distribution of information to patients.

Medical practitioners are understandably concerned about inadvertently breaching the Act and the risk of prosecution while this legislation remains in place. While assessments for eligibility for voluntary assisted dying can already be conducted via telehealth in South Australia, removing further legislative barriers will allow for better education for patients, their families and medical practitioners when seeking advice and support for the administration of voluntary assisted dying medication.

SA Health continues to work with State and National colleagues to support the use of telehealth for voluntary assisted dying to ensure equity of access to patients at end of life, in a safe manner.

Interpreting the legislation in real time

To ensure the delivery of safe, timely and accessible services in accordance with legislation, the VAD Operations team work closely with SA Health’s Legal team to interpret the legislation in a range of real-life scenarios.

This has driven a number of changes to systems and processes and supported timely decision-making in line with the intention of the Act.

For example, some General Practitioners had expressed concerns that they were unsure whether restrictions on initiating a discussion about voluntary assisted dying extended to having communications materials about voluntary assisted dying displayed in their waiting rooms.

In response to these requests, SA Health was able to confirm that providing general information in a common area, for example webpages or notices or flyers located in a health practice waiting room, is not considered to be initiating a discussion about or suggesting voluntary assisted dying to a patient and the Clinical Guidelines were updated accordingly.

Updates to the Voluntary Assisted Dying Clinical Portal and mandatory forms

In response to day-to-day practice and lessons learned, a range of system enhancements to the Voluntary Assisted Dying Clinical Portal forms have been deployed to promote compliance with the requirements of the Act, better streamline services and provide clearer communication to practitioners. This includes the following updates:

  • an additional field to allow practitioners to record greater detail on the patient’s life expectancy within the assessment form, allowing for greater transparency where a person’s Final Request is made in less than nine days from the First Request, in line with the requirements of the Act
  • an additional field to allow practitioners to record greater detail on a patient who has a neurodegenerative disease that will cause their death in 6-12 months, to provide an additional reminder to Coordinating Practitioners that they must refer the patient for a specialist opinion
  • an additional field for people who witness a Written Declaration to be able to record their relationship to the patient, to monitor safeguards against coercion
  • on-SA Health medical practitioners can choose to upload a National Police Check when they register to participate in voluntary assisted dying, streamlining credentialling processes in public hospitals.

SA Health will continue to make improvements to the system and forms in response to lessons learned.

Patient support module

The Voluntary Assisted Dying Clinical Portal was designed to capture information and facilitate access to voluntary assisted dying for people upon a making a First Request. In the first five months of operation, voluntary assisted dying support services identified there was a gap in information gathering and sharing about prospective patients who may be seeking to make a First Request but had not yet done so.

To resolve this, a Patient Support module is being developed in the Voluntary Assisted Dying Clinical Portal that will allow Care Navigators and VAD Liaison Nurses to record and track support services provided to patients who contact them.

The Patient Support module will streamline information sharing between voluntary assisted dying support services and enable greater monitoring and oversight of the number of patients seeking to access voluntary assisted dying before making a formal first request.


General Practitioners and other private medical practitioners are an important part of care for many patients who may be in a public hospital and on the voluntary assisted dying pathway. The SA Health Credentialling Policy requires practitioners who work privately, including General Practitioners, to be credentialled to provide services if they are operating within a public hospital.

Credentialing is a process that health service organisations use to verify the qualifications of a clinician to determine their ability to provide safe, high quality health care services. This is an important process for patients who are supported to access voluntary assisted dying by a private practitioner and require an assessment or other service while admitted at a public hospital.

To support this process, the VAD Operations Team works closely with Local Health Network credentialling teams to proactively credential medical practitioners who participate in voluntary assisted dying.