Just as we at Marie Curie rely on our fantastic volunteer collectors and supporters, the new boards will need the support, experience, skills and services supplied by the third sector which complement the vital services offered by the NHS and local authorities. Services provided by the third sector are often a key piece of the jigsaw when it comes to ensuring that people receive the care that they want and need.
The third sector already makes a significant contribution to palliative care services in Scotland. Independent hospices spend nearly £60 million every year and Marie Curie spends a further £12 million on top of that. That doesn’t include all the in-kind resource that comes from substantial volunteer support for services. Current Scottish Government guidance is for 50 per cent of funding for adult hospices to come from NHS boards, which leaves a sizeable chunk needed from public donations. All of the community and nursing services carried out by the third sector are also heavily subsidised by the charities that provide them.
If the third sector was to disappear from the world of palliative and end of life care in Scotland then the shortfall that would need to be found by the statutory sector would be massive. In today’s environment where every penny in health and social care is closely scrutinised it would be hard to see how they could pick up the short fall without cutting other services significantly.
This does not factor in the money that palliative care services, delivered by the third sector, save the statutory sector too. Palliative care services often support people to live at home for longer and help reduce hospital admissions and readmissions. They can also support people to be discharged from hospital if they want to go home, helping put in place a health and social care package to enable that. Just one of our initiatives, the Marie Curie’s Glasgow Fast Track Service has helped save up to 20,000 hospital bed days as those patients were able to be cared for at home. Research by the London School of Economics suggests that investing in palliative care services to reach more of those in the last week of life could lead to savings of nearly £7 million a year in Scotland.
At present, we know that an estimated 11,000 people miss out on either generalist or specialist palliative care every year in Scotland. With Scotland’s aging population and more and more people living with multiple, complex, chronic and terminal illnesses the number of people dying each year will go up by 12 per cent by 2037. This will mean an additional 7,000 people dying each year, of which around 5,000 will need palliative care based on current estimates. We need to make sure that services are reaching everyone, are sustainable and are fit for the future.
Reshaping Care for Older People has proven that the third sector can play a crucial and successful role in designing and delivering integrated services in partnership with NHS Boards, local authorities and others from the third sector. These services have improved patient outcomes and delivered a more patient centred approach reflecting their needs and wishes.
So as we move into the new world of integrated health and social care, Integration Joint Boards and the third sector must work together as a priority to ensure that all people living with a terminal illness get the care they need. This will be essential if the Government is to be able to meet its new objective that everyone who needs palliative care gets it by 2021. It is crucial to ensure Scotland is prepared for current and future demand.
l Richard Meade is Marie Curie Head of Policy & Public Affairs, Scotland
l Visit www.mariecurie.org.uk/change