The Canadian Atlas of Palliative Care
The British Columbia Atlas of Palliative Care
Pallium Canada has officially launched the British Columbia Edition of the Canadian Atlas of Palliative Care. This groundbreaking resource provides a comprehensive, data-driven snapshot of the status of palliative care across several domains in the province and its regions.
Mapping palliative care in British Columbia
As a member of the World Health Assembly, Canada recognizes palliative care as an essential part of every health care system. The newly launched British Columbia Edition of the Canadian Atlas of Palliative Care is a unique Canadian resource that examines palliative care at a provincial and regional level, across various domains, such as policy, services, and education. The Atlas consolidates provincial and regional level information into a single, interactive resource, providing a comprehensive view of palliative care across British Columbia.
Developed by Pallium Canada, with support from the Division of Palliative Care at McMaster University and the BC Centre for Palliative Care, the Atlas not only highlights the strengths of British Columbia’s palliative care system but also identifies some gaps.
By offering evidence-driven insights, it serves as a powerful tool to inform meaningful action and drive improvements in care. This Atlas is a pivotal step toward ensuring that every British Columbian can access compassionate, high-quality care at the end of life, no matter where they live.
Partners
The British Columbia Edition of the Canadian Atlas of Palliative Care was commissioned, supported, and collaboratively led by Pallium Canada in partnership with key stakeholders. Their contributions and expertise helped shape this resource.
What is a Palliative Care Atlas?
Palliative care atlases have proven to be powerful and transformative tools for understanding and improving palliative care systems worldwide. By offering both graphical and textual representations of the state of palliative care across different domains and indicators in a jurisdiction, they highlight areas of excellence and identify opportunities for improvement. Atlases have previously been developed for countries across Africa, Europe, the Middle East, and South America, and these Atlases have proven impactful in celebrating successes as well as driving improvements.
The Canadian Atlas of Palliative Care was first initiated by Pallium Canada in 2019, in collaboration with the Dr. Joshua Shadd Pallium Canada Research Hub at McMaster University.
About the British Columbia Edition of the Canadian Atlas of Palliative Care
The British Columbia Edition of the Canadian Atlas of Palliative Care offers a snapshot of palliative care in the province as of 2023–2024. It is informed by the insights and expertise of regional palliative care leaders from across the province, who generously contributed their time and knowledge. Drawing on global best practices, the Atlas adapts internationally recognized domains and indicators used in the international atlases to align with the Canadian health care system.
The online story map of the British Columbia Edition of the Canadian Atlas of Palliative Care is an interactive tool that allows users to explore detailed data on palliative care services across the province. This is complemented by a comprehensive PDF report of the Atlas. With the Atlas, you can:
Explore palliative care by health region. The Atlas provides a detailed breakdown of palliative care services across different health regions in BC, allowing users to compare availability, identify disparities, and understand regional variations in service delivery.
Identify gaps and opportunities for improvement across services, education, policies, resources and focused populations. The Atlas helps guide strategic investments and planning to improve the presence of palliative care and access to different types of palliative care services.
Compare key aspects of palliative care across different domains, from specialist services to primary and generalist-level integration in primary care, long-term care, and other health care settings. The Atlas examines access, capacity, and coordination, as well as policies, processes, and education.
Enhance transparency and accountability in the health care system. The Atlas serves as an open, evidence-based resource that fosters dialogue and informed decision-making among policymakers, health care leaders, and the public.
Key findings
The following highlights the key findings and insights derived from the full version of the Atlas, offering a concise overview of the province’s palliative care landscape and the opportunities to enhance access and quality of care. These findings are crucial in guiding future policy, resource allocation, and service delivery to ensure equitable, high-quality care for all British Columbians.
Palliative care in British Columbia is robust, but regional gaps exist
British Columbia has a vibrant and well-developed palliative care system with high levels of access in most regions to specialist-level palliative care services in hospital and community settings. However, rural and remote communities continue to face significant barriers struggling with both limited-service availability and challenges in recruiting specialized professionals, leaving many without timely, specialized care.
Community-based palliative care is well developed, particularly in larger areas
Across the province, community-based palliative care is strong, especially in medium to large urban centers. These areas benefit from home-based care services, hospice care, and strong community support systems. However, some rural and remote regions have less than 10% of the coverage they need to access specialist palliative care clinicians. In these regions, access is largely virtual and, in many regions, after hours support relies on the provincial physician-led on call line.
The BC Centre for Palliative Care is a key driver of innovation and system integration
The BC Centre for Palliative Care (BCCPC) plays a crucial role in advancing palliative care. It supports best practices, fosters collaboration, and promotes integrated care models across the province. Its initiatives, including the Compassionate Communities movement and their LTC Collaborative, are empowering communities and health care providers with the tools and support needed to improve palliative care delivery.
High levels of community engagement, particularly in volunteerism
British Columbia has a highly engaged palliative care community, with over 120 Compassionate Communities initiatives supported through a seed grant program through the BC Centre for Palliative Care, and a strong volunteer network supporting palliative care at the grassroots level. Volunteers, caregivers, and hospice programs serve as vital hubs of support, strengthening local networks of care and providing essential emotional, social, and practical assistance to individuals and families.
Palliative care bed availability is uneven with an overall lower-than-needed availability of palliative care unit beds
Palliative care bed availability varies significantly across the regions, with many areas falling short of adequate capacity. While hospice bed availability is largely adequate, access to dedicated palliative care unit (PCU) beds remains limited.
- Vancouver Coastal is the only region meeting the minimum number of both PCU and hospice beds.
- Fraser Health has only half of the required minimum number of PCU beds but meets the minimum number of hospice beds.
- Northern Health and Island Health have no dedicated PCU beds and instead rely on designated PCU beds, which may be reassigned.
- Interior Health has neither dedicated nor designated PCU beds and depends entirely on hospice beds, which meet the minimum threshold, to support the region.
Hospitals provide high levels of access to specialist palliative care teams
Most medium to large hospitals in British Columbia has access to specialist palliative care teams, ensuring access to consultant expertise. However, the overall integration of palliative care across various hospital inpatients and outpatient services is minimal to low overall, especially for non-cancer services. Better integration of palliative care within cancer and non-cancer services is needed to improve care. All physicians in the province, within hospitals and communities, have access to a provincial on-call palliative care physician telephone consultation service whenever necessary. This is a vital resource, but further integration into everyday patient care is crucial to improve overall care delivery
Go beyond the key findings
The interactive British Columbia Edition of the Canadian Atlas of Palliative Care offers a comprehensive look at palliative care across the province. Explore regional data, compare service availability across different domains, and uncover insights to drive meaningful change.
Dive deeper into the British Columbia Edition of the Canadian Atlas of Palliative Care
Want to dive deeper into the findings of the British Columbia Edition of the Canadian Atlas of Palliative Care? Join an upcoming Palliative Care ECHO Project session to dig into the key findings, strengths and opportunities to improve palliative care access in BC.
Date: April 24, 2025, from 12:00–1:00 p.m. PST
Presenters: Jeffrey Moat, CEO of Pallium Canada, and Dr. Leonie Herx , MD, PhD, CCFP(PC), FCFP, Project Co-lead and Co-Principal Investigator of the British Columbia Atlas of Palliative Care
The Impact
The British Columbia Edition of the Canadian Atlas of Palliative Care identifies areas of success and celebration and serves as a catalyst for improvements, helping funders, policymakers, the media, health care analysts, health care planners, educators and the community improve their understanding of the status of palliative care in the province and its regions.
British Columbia has made significant strides in palliative care over the past two decades, improving access and services across the province. The Atlas highlights our progress and the work that is still needed to ensure all British Columbians with serious illness have equitable access to quality, compassionate care. We are proud to have been a part of this important step toward strengthening palliative care across B.C.
Dr. Eman Hassan
Executive Director of the BC Centre for Palliative Care
The British Columbia Palliative Care Atlas is a transformative resource. It provides British Columbia’s political decision-makers, health care providers, and community leaders with the vital data and insights required to drive lasting change and advance equitable access to palliative care for everyone, no matter where they live. This is a historic moment in our journey to ensure that every British Columbian receives the compassionate, high-quality palliative care they deserve.
Jeff Moat
CEO, Pallium Canada
British Columbia has made significant strides in palliative care over the past two decades, demonstrating progress across multiple domains. However, there remain important opportunities for further improvement to ensure equitable access and high-quality care for all.
Dr. José Pereira, MBChB, CCFP(PC), MSc, FCFP, PhD
Scientific Advisor and Co-Founder, Pallium Canada
The British Columbia Edition of the Canadian Atlas of Palliative Care provides a comprehensive map of palliative care across key domains and indicators. It highlights areas of strength and innovation that can be scaled and spread while identifying gaps and opportunities to expand access to quality palliative care across the province.
Leonie Herx MD PhD CHE CCFP(PC) FCFP
Palliative Medicine Consultant Physician
Funding
The British Columbia Edition of the Canadian Atlas of Palliative Care would not have been possible without the shared vision and generous donations by the following supporters:
Commonly asked questions
What is a palliative care atlas?
A palliative care atlas is a resource that provides a visual and text-based overview of the status of palliative care across several domains, within a specific region or country. They highlight strengths and excellence, identify gaps, and inform health care planning with the goal of improving palliative care systems.
How does this Atlas support improvements in palliative care?
By mapping the availability and accessibility of palliative care services across British Columbia, the Atlas helps identify areas where resources are needed most. It serves as a tool for advocacy, informing policy development, and guiding health care planning to strengthen palliative care services in the province.
Will there be other provincial editions of the Canadian Atlas of Palliative Care?
Yes. The British Columbia Edition of the Canadian Atlas of Palliative Care is the first provincial edition of the Canadian Atlas of Palliative Care. Future editions will expand to other provinces, with Ontario and Alberta editions set to launch in 2025.
Why doesn’t this edition of the Atlas include palliative care for Indigenous populations?
This edition of the Canadian Atlas of Palliative Care does not seek to reflect palliative care services and programs of First Nations, Inuit, or Métis peoples in Canada. Instead, with humility and in the spirit of reconciliation, Pallium Canada is dedicated to collaborating in a distinct process, led and developed by Indigenous Peoples, to describe palliative care across Turtle Island provided by, with and for Indigenous peoples. Such mapping will adhere to the First Nations Principles of Ownership, Control, Access, and Possession (OCAP®), Manitoba Métis principles of OCAS (Ownership, Control, Access and Stewardship), and Inuit Qaujimajatuqangit.
What health regions are covered in this Atlas?
The British Columbia Edition of the Canadian Atlas of Palliative Care covers five regional health authorities in the province: Interior Health, Fraser Health, Vancouver Coastal Health, Vancouver Island Health, and Northern Health.
Will this edition of the Atlas be updated?
Yes, like other palliative care atlases, the British Columbia Edition of the Canadian Atlas of Palliative Care is intended to be updated every five years. Regular updates will help track changes, improvements, and emerging needs in palliative care services across the province.
How can the Atlas be used?
The British Columbia Edition of the Canadian Atlas of Palliative Care serves as a valuable tool for policymakers, health care providers, researchers, and communities to assess the state of palliative care in the province. It helps identify successes, gaps, and opportunities for improvement, guiding decision-making and future planning to improve palliative care accessibility and quality.
Are there other palliative care atlases besides this one?
Yes, palliative care atlases have been developed for various regions worldwide. One of the earliest atlases was published in 2000, covering seven European countries. Since then, the Atlantes Program at the University of Navarra has led the development of atlases for Europe, Africa, the Middle East, North Africa, and Latin America. These atlases provide valuable insights into palliative care services, helping to drive improvements globally. The Canadian Atlas of Palliative Care follows this tradition, offering a province-by-province view to inform and improve palliative care in Canada.
What data does the British Columbia Edition of the Canadian Atlas of Palliative Care include?
The British Columbia Edition of the Canadian Atlas of Palliative Care provides a cross-sectional view of palliative care services across the province. It examines health care services, policies, system performance, education, community engagement, and professional activities. Some indicators, such as the presence of a palliative care unit or policy, are reported as “Yes,” “No,” or “Partial,” while others, including palliative care integration levels, are assessed based on expert judgment. Where possible, the Atlas applies established benchmarks, such as the recommended number of palliative care beds per population, to evaluate adequacy.
Where does the data for the British Columbia Atlas of Palliative Care come from?
The British Columbia Edition of the Canadian Atlas of Palliative Care uses a mixed-methods approach, combining surveys, interviews, and focus groups with health care professionals, policymakers, and regional palliative care leaders. Where available, publicly accessible data sources were also used. Expert input and consensus reviews helped validate findings to ensure accuracy. While some data gaps exist due to resource limitations or availability, multiple perspectives were incorporated to provide the most comprehensive overview possible.
How were the findings of this Atlas validated?
The data in this Atlas was validated through objective measures (e.g., presence of policies or services), expert judgment for harder-to-measure indicators, and established standards like the Catalonia Formula for palliative care beds. Multiple stakeholder reviews helped ensure accuracy and reduce bias.
Who contributed to the development of the British Columbia Edition of the Canadian Atlas of Palliative Care?
The British Columbia Edition of the Canadian Atlas of Palliative Care has been informed by the insights and expertise of regional palliative care leaders and practicing health care professionals from across the province. These experts generously contributed their time and knowledge to provide a comprehensive overview of the current state of palliative care in their respective regions.
Mapping the future of palliative care in Canada
The British Columbia Edition of the Canadian Atlas of Palliative Care is part of a national effort to map access to palliative care across Canada. The Ontario and Alberta editions are currently in development.
Data alone doesn’t drive change; people do. The Atlas is a vital tool for policymakers, health care leaders and communities to push for better access, stronger collaboration, and a future where high-quality palliative care is available to all. By raising awareness and supporting evidence-based decision-making, we can drive meaningful change in health equity and ensure that every Canadian has access to high-quality palliative care.
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