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Scottish Partnership for Palliative Care comments on The Inescapable Truth about Dying in Scotland (a new report by Dignity in Dying)

Following the recent publication of The Inescapable Truth by Dignity in Dying, the Scottish Partnership for Palliative Care has published the following comment on the report:

SPPC acknowledges the stories of individual suffering contained within the report recently published by Dignity in Dying. The relief of suffering and the promotion of wellbeing in difficult life circumstances is the central concern of palliative care. It is important that the voices of people who have bad experiences are heard so that we can keep making improvements.

Scotland is internationally recognised as having some of the best palliative and end of life care in the world. Every day thousands of staff in hospices, hospitals, care homes and in the community provide care which helps people and their families to get through the difficult times which can come with death, dying and bereavement. Most people in Scotland will have seen or experienced examples of such care, and be reassured that experiences of the type described in the Dignity in Dying Report are relatively rare.

Specialist palliative care, like any part of our health and social care system, cannot claim to be perfect 100% of the time. However, modern palliative care has made great progress in improving people’s experiences towards the end of life, and it is very unusual for doctors to run out of options to control pain. As the report acknowledges, in the rare cases where symptoms can’t be reduced to a level which a person feels able to bear, there is the option for a doctor to use medication/sedatives to reduce the person’s conscious awareness of those symptoms.

The provision of palliative care in Scotland is guided by a range of relevant guidelines and standards, including Scottish Government Guidance Caring for People in the Last Days and Hours of Life, GMC Guidance Treatment and Care Towards the End of Life: Good Practice in Decision-Making andthe NHS Healthcare Improvement Scotland Scottish Palliative Care Guidelines.

Modern palliative care has made great progress in improving people’s experiences towards the end of life, and more improvements can be made. There must be a stronger focus in Scotland on improving the care which these people receive towards the end of life. Around 57,000 people die annually in Scotland. Of these it is estimated that as many as 47,000 people will have needs arising from living with deteriorating health for years, months or weeks before they die. Most people will be at home, in hospital or in a care home towards the end of life. There is a need to maintain adequate staffing levels to provide care and support in these settings. There is a need for training and education to build the skills and confidence of these staff. There is also a need to invest in specialist palliative care services so that they can both help people with more difficult symptoms, and also provide advice and support to other staff.

There is clear evidence that investments of the sort outlined above will improve people’s experiences of death, dying and bereavement. Scotland needs to become more ambitious about ensuring that everyone gets the best care possible, whether at home, in hospital, in a care home or in a hospice.

The SPPC's full response can be viewed here: Scottish Partnership for Palliative Care comment on The Inescapable Truth about Dying in Scotland (a new report by Dignity in Dying)

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