Palliative care for all when the end is approaching is still the national goal – Richard Meade

In 2016 the Scottish Government set out an ambitious, and very welcome, vision that by 2021 everyone who needs palliative care will have access to it.
Many care and nursing homes are at capacity, as well as care at home services,                                            which are toiling to provide services, while hospices are also struggling financiallyMany care and nursing homes are at capacity, as well as care at home services,                                            which are toiling to provide services, while hospices are also struggling financially
Many care and nursing homes are at capacity, as well as care at home services, which are toiling to provide services, while hospices are also struggling financially

We are rapidly approaching that time, and despite great efforts we are unlikely to meet that vision. But it is an almost impossible task. Palliative care can include so much and be delivered by so many. It would be impossible to know if everybody living with a terminal illness received all of the care they need, and it is so easy for the smallest most important thing to be missed. However, the ambition is a worthy one.

A society that strives to ensure that everyone who will be affected by dying, death and bereavement has the best possible experience, is one that Marie Curie believes passionately we should be working for. That experience should reflect what is most important to people.

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Thanks to recent Marie Curie-led research, we are starting to see a developing picture of what care and support for people living with a terminal illness will look like in Scotland by 2040.

Richard Meade, Head of Policy and Public Affairs, Scotland, Marie CurieRichard Meade, Head of Policy and Public Affairs, Scotland, Marie Curie
Richard Meade, Head of Policy and Public Affairs, Scotland, Marie Curie

The number of people dying in Scotland will increase by 7,000 a year to over 65,000 by 2040, with people living longer into their mid-80s. By 2040 45 per cent of all deaths will be people over 85. Our dying population will become increasingly older, frailer and living with multi-health conditions, which will create a new level of complexity in the care they will need. Many more people will die with dementia, cancer and/or frailty, as well as other health conditions.

Further Marie Curie-led research has shown that if current trends continue then two-thirds of Scots will die in the community, either in a care home, their own home or a hospice, but experts have said that this won’t happen without significant investment in community services including social care and palliative care services.

At present there are considerable pressures right across the health and social care system. Many care and nursing homes are at capacity, as well as care at home services, which are struggling to provide services, particularly where a rapid response is needed. Hospices are also struggling financially with less and less statutory money to support them and ever greater costs needing to be met out of charitable contributions. GP and district nurse numbers are falling, as well as challenges facing other practitioners.

All of these organisations and people play a huge part in ensuring people get the care and support they need from the point of a person’s terminal diagnosis right up until their death.

Knowing this can help us prepare for the future and to ensure our society and our services are ready to meet the changing needs of those who are approaching the end of life.

So what next? The Scottish Government’s action plan for palliative care is due to finish next year. Palliative care services are the responsibility of local health and social care partnerships. In short, everyone has a part to play and we need to be bringing all these people together to start planning and preparing for how we meet the future.

Health and Social Care Partnerships play a vital role in commissioning local services to meet local needs. We have seen a number of partnerships produce local action plans for palliative care and this is very welcome. The rest need to follow suit and involve all local stakeholders in that process.

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There is a national role to be played too and one where Scottish Government can show leadership in setting out our country’s ambition. We know that dying, death and bereavement remains a taboo across society with many people, including professionals and practitioners. How we tackle this taboo and drive a cultural change isn’t the responsibility of government, but government can play a leading in role in helping to set the conditions and support the changes that can come. As we move toward 2021 and the next Scottish Parliament election, we need the next Scottish Government to be as ambitious as the current one in setting out a clear vision that everyone who needs palliative care should have access to it. This must be supported by a plan of action developed by all key stakeholders and given the proper resource to drive the changes we need to see.

We only get one chance to get end of life care right for someone, and our ambition to see this happen should not waver.

Richard Meade, Head of Policy and Public Affairs, Scotland, Marie Curie