Scotland is in the top 10 countries in Europe for levels of palliative care, although a new study has said there remains “room for improvement”.
For the first time, academics at Glasgow University compared the level of end of life care provided in Scotland with that in the rest of Europe, including elsewhere in the UK.
There are 23 specialist palliative care (SPC) inpatient units in Scotland, containing a total of 349 beds. In addition, there are 27 SPC hospital support teams and 38 SPC home care teams.
Relative to other European Union countries, Scotland ranked seventh for provision of SPC inpatient units and hospital support teams, and fifth for home care teams.
Statistics for Scotland had only been included with UK data before, but the Scottish Atlas of Palliative Care, which was published in 2016, meant more detailed information was available. The Glasgow University team analysed this and compared it with the European Atlas of Palliative Care.
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David Clark, professor of medical sociology at the university, said: “The results are encouraging. Scotland is in the top 10 EU countries for all three types of service - not many countries do as consistently well across the board.
“However, the level of coverage of specialist home care teams shows room for improvement.”
According to the research, published in BMJ Supportive and Palliative Care, the provision of services in Scotland was “found to be well balanced and broadly reflective of that in the rest of the UK, with Scotland’s position being higher than the rest of the UK for inpatient and home care teams but lower for hospital support team”.
The coverage provided by specialist palliative care hospital support staff was described as being at “optimal” level, however the study showed there is “lower than recommended coverage” when it comes to the provision of inpatient units and home care teams.
The shift to provide more care at home or in a homely setting may have resulted in a lower than anticipated level of inpatient SPC beds, the report said.
But it added: “The coverage of home care teams in Scotland was less than optimal. This is an important finding. If the policy of shifting the balance of care from hospitals to community settings is to be translated into practice, community services must be adequately resourced.”
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Public health minister Aileen Campbell said: “We welcome this research which shows that Scotland continues to be a leader in providing high-quality specialist palliative and end of life care. This is a tribute to the compassion, commitment and dedication of those working across our health and social care services.
“This work serves to highlight the importance of developing services in community settings to meet local need. This is one of the overarching themes of our Strategic Framework for Action on Palliative and End of Life Care and this research will be helpful in taking this work forward.”
Richard Meade, head of policy and public affairs for Marie Curie in Scotland, said: “This important new study highlights that we need to do more to reach terminally ill people in their communities.
“Supporting people and developing resources in the community not only allows them to be cared for at home, where they would most like to be, but can also help reduce admissions and stays in hospital.
“We know that around a quarter of those who need palliative care in Scotland do not get it. The Scottish Government has committed to doubling palliative care services in the community and we look forward to seeing this progress.”
Mark Hazelwood, chief executive of the Scottish Partnership for Palliative Care, said: “As well as delivering expert care directly, specialist palliative care services provide education, support and advice to other practitioners across the health and care system.
“We welcome this research as part of a wider discussion of the adequacy of services available in Scotland to meet the needs of people experiencing declining health, death, dying and bereavement.”