Discover the Canadian Atlas of Palliative Care: Ontario Edition, the first resource of its kind in Ontario to map out how palliative care is delivered and accessed across the province.
Mapping palliative care across Ontario
As a member of the World Health Assembly, Canada recognizes palliative care as a human right and an essential part of health systems. Until now, no single resource has offered a complete, data backed overview of palliative care across Ontario.
The Ontario Edition of the Canadian Atlas of Palliative Care is the first-of-its kind resource to consolidate data from both provincial and regional levels across key domains such as policy, services, and education. Developed by Pallium Canada with support from the Division of Palliative Care at McMaster University, the Atlas highlights both the strengths of Ontario’s palliative care system and areas where critical action is needed.
Featuring an online story map and complementary PDF report, this resource empowers decision-makers and communities with data and insights to advance equitable, high-quality care for all Ontarians, no matter where they live.
Partners
The Ontario Edition of the Canadian Atlas of Palliative Care was commissioned, supported, and collaboratively led by Pallium Canada in partnership with the Division of Palliative Care at McMaster University.
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.
About the Canadian Atlas of Palliative Care: Ontario Edition
The Ontario 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, front-line health care professionals, managers, directors, policymakers, educators, researchers and health care and community advocates from across the province, who generously contributed their time and knowledge.
Explore palliative care by Ontario Health region, allowing users to view availability, identify disparities, and understand regional variations in service delivery
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.
Identify gaps and opportunities for improvement across services, education, policies, resources and focused populations.
Enhance transparency and accountability in the health care system 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.
There is a proportionally significant lack of acute palliative care beds
While there is an adequate number of palliative care unit (PCU) beds (579); most function primarily as end-of-life beds (similar to hospice) or as continuing care beds. As a result, there is a significant lack of acute palliative care beds in Ontario.
- North West and North East regions have no dedicated PCU beds and instead rely on designated beds that serve varied needs and may be reassigned based on demand.
- East and Central regions have an inadequate number of PCU beds and rely primarily on mixed units, some of which support acute symptom management or end-of-life care.
- Toronto and West regions have an adequate number of dedicated PCU beds, but the limited availability of bed profile types and mixed units create challenges in evaluating access and availability.
Incomplete data and undefined standards impede effective palliative care planning
The Atlas identified significant gaps in the standardized definitions and available data for palliative care unit (PCU) beds across Ontario. Variations in PCU profiles, coupled with discrepancies between publicly available data and actual bed availability, have led to confusion among regional and provincial bodies, hindering system planning, coordination, and resource allocation.
Equitable access to palliative care remains a significant challenge
Despite some emerging efforts, equitable access to palliative care is not yet a reality for all Ontarians, leaving many underserved populations without the support they need. Pediatric palliative care services are available in some regions but remain unevenly distributed. Many larger communities lack local options, and families often depend on virtual support, without the option of hospice support. Similar challenges affect 2SLGBTQI+ persons, homeless and vulnerably housed persons, incarcerated persons, and refugees and immigrants. The province lacks coordinated strategies to address their needs, resulting in inconsistent and often suboptimal care. Promising models, however, are emerging and demonstrate the potential for a broader impact across populations and regions.
Ontario has a strong foundation of provincial frameworks to guide palliative care
The Ontario Palliative Care Network’s Health Service Delivery Framework and the Ontario Provincial Framework for Palliative Care, developed following the Compassionate Care Act (2020), offer direction to improve access, coordination, and quality of palliative care across the province.
Primary-level palliative care is largely delivered by specialist teams in many subregions
In rural regions and in some large- and medium-sized urban centres, there are some primary care physicians and primary care clinics providing primary palliative care to their own patients — often supported by specialist palliative care teams — but these are the exception rather than the rule.
Efforts to build primary palliative care capacity remain inconsistent across the province. While some subregions and areas are working to build primary palliative care capacity, ongoing gaps in training, workforce, infrastructure, and system support continue to limit the ability of family physicians and primary care clinics to deliver palliative care, particularly to provide home- and after-hours services.
There is a strong community of palliative care researchers with active palliative care research programs within university-affiliated centres
These programs are active interprofessional and interdisciplinary research efforts that contribute to the advancement of palliative care practice and education across the province and country.
Go beyond the key findings
The interactive Ontario 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.
Far too many individuals still lack timely access to palliative care, and for those who do, it often comes very late, only in the final days and weeks of life. With the Ontario Atlas of Palliative Care, we can equip policymakers, administrators, and health care leaders with a foundational assessment of palliative care’s current status across health regions. This is a crucial step towards informed decision-making for the integration and advancement of palliative care within our health care systems.
Jeff Moat
CEO, Pallium Canada
The absence of a singular reporting source or comprehensive data repository has left a significant gap in our understanding of palliative care in Canada. The Canadian Atlas of Palliative Care: Ontario Edition is a critical step towards mapping access to palliative care services across different care settings and patient populations and enhancing the delivery of palliative care across the province.
Dr. Leonie Herx
Palliative Medicine Consultant Physician
Funding
The Ontario 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 Ontario, 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, there are currently two provincial editions: Ontario and British Columbia. The Alberta edition is 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 Ontario Edition of the Canadian Atlas of Palliative Care covers six Ontario Health regions in the province: Toronto, Central, East, West, North East and North West.
Will this edition of the Atlas be updated?
Yes, like other palliative care atlases, the Ontario 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 Ontario 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 this Atlas include?
The Ontario 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 this Atlas come from?
The Ontario 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 this Atlas?
The Ontario 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 Ontario edition of the Canadian Atlas of Palliative Care is part of a national effort to map access to palliative care across Canada.
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.
Back