End of life care in Scottish hospitals

Last Tuesday, 10 November, Marie Curie and the University of Glasgow co-hosted a seminar, End of life care in Scottish hospitals: opportunities for wider engagement, at the Glasgow Concert Hall.

The seminar was held to discuss and debate research carried out by the University of Glasgow and partly funded by Marie Curie, which looked at the imminence of death in in-patients in Scottish Hospitals in 2013. This was a follow-up study to one carried out last year for 2010, and confirmed findings that one out of 10 patients in Scottish hospitals will die in their current admission, and that three out of 10 patients in hospital are in the last year of life.

We heard from three speakers:

  • Professor David Clark, who led the research for the University of Glasgow
  • Anne Harkness, the director of acute services in NHS Greater Glasgow, who has responsibility for the new Queen Elizabeth University Hospital
  • Professor Craig White, the National Clinical Lead for Palliative Care in Scotland and lead on developing the new Strategic Framework for Action on Palliative and End of Life Care

The discussion points

The speakers were followed by a Question Time-style discussion with the panel and an audience of over 180 people.

Delegates explored the role of the hospital in identifying patients in need of palliative care and at the end of life. With the study highlighting a consistent picture of a large population of in-patients clearly in the last year of life, this presented, to some, an opportunity for engagement and identification. This  could then lead to earlier and greater access to specialist and general palliative care. However, this is challenged by the many patients who are in hospital for only a few days before being discharged. Would such conversations be appropriate, especially if the patient is then discharged into the community with potentially no additional support? The role of integrated health and social care functions was recognised as a crucial bridge between the acute and the community.

The changing demographic of more people living into old age with multiple conditions was highlighted, as it means that many people’s decline in health is uncertain and this can pose a significant challenge to care professionals. Extra responsibilities around having conversations with patients with potential palliative needs must be embedded into their work and not seen as an extra add-on which might lead to it being missed or rushed because of time pressures.

Wider issues

Wider issues were also debated including the need for society as a whole to be more open and prepared to talk about death and dying, and what people want when time becomes short. Delegates agreed that such important issues transcend health and social care and need to be included in education, transport and every area. The role of volunteers and carers in the support of those living with a terminal illness was also recognised as being vital in ensuring people getting good care.

The Scottish Government’s new strategic framework for action is due to be published by the end of the year. It is hoped that many of these positive ideas will be realised and that barriers to care are challenged so that everyone will be able to receive the excellent palliative care and support at the end of life that Scotland is capable of giving.

Funding for the seminar was secured through a grant from the Economic and Social Research Council  , which was hugely appreciated.

You can read more about the study and the seminar, as well as watch interviews with key perspectives, on the University of Glasgow’s blog  .