Exclusive:Too many Scots dying in hospital, leading hospice provider warns

Charity Marie Curie Scotland says people should have to spend final months in A&E or calling out ambulances

Scotland’s largest provider of hospice care beds has warned too many Scots are dying in places where "they don't want or need to be", amid criticism of the reliance on hospital settings for end-of-life care.

Marie Curie Scotland has called on the Scottish Government to commit to a long-term ambition to deliver “equitable and accessible” care, which would in turn lessen the burden on an under-pressure NHS by preventing people from having to visit A&E departments to call out ambulances.

The largest independent provider of end-of-life care in Scotland pointed out that six times as much public money was allocated to supporting people in the final year of life as hospital inpatients than the sum devoted to providing them with primary, community health and hospice care.

Marie Curie Scotland has said there must be more ‘equitable and accessible’ care. Picture: Getty Images | Getty

It comes as the charity is consulting with staff at risk of redundancy in the wake of the decision by several health and social care partnerships (HSCPs) across the west coast of Scotland to take overnight care service provision in-house, a decision it said had left it “saddened and disappointed”.

Amid ongoing financial pressures across the hospice sector, Marie Curie Scotland pointed to research it commissioned that found public expenditure for people living in Scotland in the last year of life across healthcare, social care and social security was in the region of £2.3 billion.

The analysis, carried out by the Nuffield Trust and the Health Economics Unit, revealed public spending on primary and community healthcare makes up 9 per cent (some £117 million) of health expenditure for people in the last year of life, with only three per cent (£39m) spent on hospice care.

Amy Dalrymple, associate Director of policy and public affairs at Marie Curie Scotland. Picture: Maveri | MAVERICK PHOTO AGENCY

Amy Dalrymple, associate director of policy and public affairs at Marie Curie Scotland, said: “The research underlines what we’ve known for a concerningly long time. Too many people and their loved ones who care for them are spending their last months of life in hospital, visiting A&E or forced to call out ambulances rather than receiving well-anticipated, co-ordinated and holistic care in the community. Most devastatingly, too many people are dying in places where they don’t want or need to be.

“There must be a clear long-term ambition for the Scottish Government to shift health expenditure on people at the end of life from hospital to community settings supported by realistic targets that can be measured. For example, a long-term target to reduce hospital expenditure by 20 per cent and a corresponding increase in expenditure on community-based health services over a 10-year period would double current expenditure on community services.

“Such a shift would enable the development and scaling of innovative services needed to ensure equitable, accessible care that is right for dying people and their loved ones.”

The changes at the HSPCs in Renfrewshire, East Renfrewshire, East Dunbartonshire and Inverclyde, which are due to come into effect at the end of next month, means 12 Marie Curie staff are at risk of redundancy, with the overnight care they provided being delivered by NHS district nursing teams.

A Scottish Government spokesman said: “We are aware of the pressures hospices are facing and strive to support independent hospices where possible. The draft Budget for 2025/2026 contains an additional £5m for charitable hospices to help address cost pressures.”