SAMWUMED PALLIATIVE CARE PROGRAMME

Palliative care is specialised medical care for people with serious illnesses that focuses on improving their quality of life. It can be provided at any stage of an illness and works alongside other active treatments. A specialised team, which usually includes a palliative trained doctor, nurse, and social worker, works in collaboration with other healthcare practitioners to provide this extra layer of support.

Palliative care helps to provide:

• Relief from symptoms like pain, nausea, fatigue, and shortness of breath
• Emotional and spiritual support, and relief from psychosocial distress
• An improved quality of life for both the patient and their loved ones by focusing on the patient’s goals, values, and overall well-being
• Care coordination for patients and their families to understand the treatment options and coordinate their care to align with the patient’s wishes
• Support for the members’ families and caregivers

The SAMWUMED Palliative Care Programme provides all eligible members, and their families, with support, quality care, and holistic management during their cancer treatment by providing an extra layer of support, which includes symptom relief such as pain management as well as relief from psychosocial distress, while enabling the home-based care approach and does not replace any existing care.

The multidisciplinary palliative care team works in collaboration with existing healthcare practitioners, including the treating oncologist and family general practitioner (GP), allowing the entire team to collaborate and coordinate the patient’s care through a secure communication platform.

The SAMWUMED Palliative Care Programme is available to eligible members at no extra cost. It is covered by the Overall Annual Limit as an alternative to hospitalisation, and does not affect your day-to-day benefits, medical savings, or your oncology benefit.

No, it does not. It’s an extra layer of care or support.

The SAMWUMED Palliative Care Programme provides an extra layer of specialised care and support for members. It is not a replacement for existing care, but is designed to complement the care you are already receiving.

You gain access to a dedicated, multidisciplinary team that can spend the extra time needed to guide you and your family through the physical, emotional, and practical challenges of your journey. This includes meaningful, timeous conversations regarding diagnosis and future care preferences, including advanced care planning, as well as psychosocial and emotional support to help navigate the disease journey.

The SAMWUMED Palliative Care Programme is separate from the SAMWUMED oncology benefit and is available to eligible SAMWUMED members at no extra cost, with cover from the Overall Annual Limit as an alternative to hospitalisation, and does not affect your day-to-day benefits, medical savings nor your oncology benefit.

Should an eligible SAMWUMED member choose to take advantage of the benefit, they will either be enrolled in the Ongoing Phase – supporting those who are still relatively active, or the Intensive Phase – supporting patients who are nearing the end stages of life.

The Ongoing Phase covers:

• Initial consultations with a palliative-trained doctor, registered nurse, and social worker, if psychosocial support is indicated
• Follow-up consultations with a palliative doctor, nurse, and social worker

The Intensive Phase covers:

Medication symptom Multi-disciplinary care (at home, or in hospital) provided by a palliative doctor, nurse, and social worker as needed. The frequency of care is decided and delivered by the assigned team

• Relief, as prescribed by the Alignd palliative doctor, from the Alignd formulary
• Home oxygen, where necessary

• Hire of a commode, hospital bed, and purchase of an eggbox mattress, where necessary
• 336 hours of home-based care at the end of life (please note that this is not a replacement for frail care)

Yes, Alignd’s Remote Access and Virtual-Only models of care offer support to patients in areas without access to a palliative doctor who visits them at home.

• Remote Access model: the palliative doctor is only available virtually, but a nurse or GP is available in person
• Virtual-Only model: both the palliative doctor and nurse or GP are only available virtually

Patients with advanced or metastatic cancer, as well as their families, will typically benefit from this extra layer of support provided by the palliative care multidisciplinary team. This includes:

• Locally advanced cancer (T4) or metastatic cancer (M1)
• High-risk cancers at diagnosis: pancreas, oesophagus, liver (HCC), bile duct, gallbladder, mesothelioma, small cell lung, aggressive thyroid or brain cancers (Stage IV)

Other life-limiting diseases may be approved by the medical scheme on a case-by-case motivation basis.

It is recommended that patients with the following be referred:

• Repeated unplanned hospital visits
• Declining performance status
• Significant weight loss or BMI ≤16
• Ongoing symptoms despite treatment

Additional clinical information will be required for certain cancers, and the Alignd clinical team will liaise directly with the referring doctor, for example, in cases of haematological malignancies such as leukaemia, lymphoma, or myeloma.

If your treating doctor is unsure whether you are eligible or not, they can contact the Alignd and they will  review your eligibility.

Treating doctors can refer all potentially eligible SAMWUMED patients directly to Alignd by emailing refferrals@alignd.co.za.

As a formal partner of SAMWUMED, Alignd has access to SAMWUMED patients’ clinical data. As such, you, treating doctors, may also receive a call or email from one of Alignd’s clinical team members when they have identified a member as potentially eligible for the SAMWUMED Palliative Care Programme.

Members are also enrolled with Alignd through other pathways, such as self-enrolment. If this is the case, Alignd endeavours to inform the treating doctor. Remember, Alignd offers an extra layer of care and support to help you cope with your cancer journey. It is not a replacement for existing care.

If you would like any more information, please contact the Alignd provider team at assist@alignd.co.za or visit Alignd’s website at www.alignd.co.za.