Scotland lagging behind in delivery of end of life care

Scotland is fairing worse than similar sized countries when it comes to delivering end of life care with around a third of people in hospital on any given day likely to die within one year.

From l to r: Professor David Clark OBE from the University of Glasgow, Lene Jarlbæk from REHPA - Knowledge Centre for Rehabilitation and Palliative Care, Professor Merryn Gott from the University of Auckland and Richard Meade from Marie Curie Experts debate end of life care in hospitals

Experts from Denmark, New Zealand and Scotland met in Glasgow earlier this week to discuss the correlation between hospital admissions and the likelihood of death.

In all three countries studies have revealed that the number of people who would benefit from palliative and end of life care but do not necessarily receive it is higher than previously thought.

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Of the three countries with similar populations, wealth and healthcare systems, Scotland has the greatest chance of a person admitted to hospital dying within 12 months at 30 per cent, compared to Denmark with 22 per cent and New Zealand which has 14.5 per cent of people dying within a year of being admitted.

This highlights the role of hospitals in caring for those at the end of life and the need for improving identification of those who would benefit from specialist support.

Compared to New Zealand, hospitals in Scotland have a higher number of older people receiving care. The proportion of those aged over 60 was 73 per cent in this country and 42 per cent for New Zealand. Just 17 per cent were over 80 years in New Zealand compared to 32 per cent in Scotland. This could be down to New Zealand having a younger population but figures will increase dramatically as populations increase and people are living longer with multiple conditions.

Professor David Clark, Wellcome Trust Investigator and expert in end of life care at the University of Glasgow, said that hospitals needed to do more around finding out that patients needs are regarding their hopes, expectations and what kind of care they would like to have.

He said: “We think there’s a great opportunity here to reach out to people who have got end of life care needs, who are present in large numbers every day – day in, day out in Scottish hospitals. There needs to be discussions around what their hopes and expectations are where they would like to be and the kind of care they would like to have”.

Health Secretary Shona Robison said: “Scotland already has a very good reputation for providing high quality palliative and end of life care. But we are determined to keep improving. One of the key areas we want to improve is on the consistency of services.

“Through our Framework for Action on Palliative and End of Life Care, we want to make sure that everyone receives high quality palliative care – tailored to their own symptoms and life circumstances.”