Rural and outer-regional areas set to carry double their population share of unmet palliative care need by 2045, Australian workforce model finds

A national Australian service-planning model projected specialist palliative care workforce supply (physicians and nurses) against mortality-driven demand from 2025 to 2045 Audit/Data. Although the palliative care physician workforce is projected to grow at 3.1% annually, the model finds this insufficient to match rising demand: by 2045, an estimated 106,470 decedents a year — over 38,500 more than at present — will be unable to access recommended levels of specialist palliative care, with almost 1.7 million Australians projected to experience unmet need cumulatively over the period.

Geographic inequity is substantial: outer regional and rural areas are projected to account for 15% of unmet need despite comprising only 8% of the population — roughly double their proportional share. Growth in the nursing workforce is modest and does not offset rising demand. The authors describe unmet need as a structural feature of the system under current trajectories, rather than a transient shortfall, and call for workforce expansion alongside greater integration of generalist practitioners and more flexible, system-level approaches to timing and delivery of palliative care.

This is a national planning model for the Australian health system, and its numerical projections are not directly transferable to the NHS. The underlying mechanism it quantifies — rural and geographically dispersed populations carrying a disproportionate share of specialist palliative care shortfall relative to urban populations — is a structural pattern relevant wherever specialist palliative care workforce is geographically concentrated.

For systems serving a mixed urban-rural population, this is a rigorous, quantified international benchmark for a question increasingly evidenced elsewhere: whether current or planned specialist palliative care workforce distribution already reflects this disproportionality, and whether generalist integration is being deliberately built into rural and dispersed-population community pathways as this evidence suggests it should be.