WHO figures show we need to do more to improve access to palliative care

Cardiff Hospice

Figures released in July from the World Health Organisation (WHO) estimate that only about 14% of people who need palliative care currently receive it. 40 million people are in need of palliative care across the world, with the majority of those living in low and middle income countries[1].

From a global perspective, the UK is considered a world leader in palliative care. According to the economist intelligence unit, we top the rankings when it comes to provision of end of life care[2]. Fantastic, job done.

Job done?

Well no, not quite. That ranking is standardised and collated through a number of figures – in fact, in one subcategory relating to the basic end of life healthcare environment we actually come 28th. The reason for our high ranking is down to the quality of provision of hospice care, some statutory sector involvement and the existence of a national end of life care strategy, all of which have more weighting than other categories.

In reality, we're actually comparable to other countries. While it's true we have a highly developed quality of specialist palliative care services, through charities such as Marie Curie and independent hospices, we actually encounter the same barriers. In Scotland alone, we estimate that of the 54,000 people who die here, up to 40,000 of them could benefit from some form of palliative care.

The reasons for this, as WHO points out, are lack of awareness among policy makers, health professionals and the public; lack of understanding about what palliative care is all about; and lack of access to opioid pain relief.

While the specialist palliative care we offer is a component of palliative care service delivery, we need a sustainable, quality and accessible generalist palliative care that is integrated throughout primary, secondary, community and home-based care. A system that supports carers and is seen as fundamental by all health and social care professionals. These are all factors we address in our Triggers for palliative carereport published in June.

Making changes in Scotland

The political and healthcare climate in Scotland is ideally positioned to make these changes. The Scottish Government is in the process of integrating health and social care, developing legislation to formally support carers, implementing a national Do Not Attempt Cardiopulmonary Resuscitation  decision-making and communication policy and developing a new strategic framework for action on palliative and end of life care.

Right now we have the chance to get it right, we have the chance to make sure everyone who needs palliative care gets it when they need it, and we have the chance to lead the way in caring for people living with a terminal illness. Let's set an example to our colleagues across the world and become the world leaders in palliative and end-of-life care that we're supposed to be.


2. Economist Intelligence Unit (2010). The quality of death: Ranking end-of-life care across the world. The Economist, 14 July 2010.