Palliative and end of life care: strategic framework for action

Foreword

Each year around 54,000 people die in Scotland. I have seen first-hand the outstanding care that is provided to many of these people through speaking with people and their families and through my visits to hospitals, GP surgeries, care homes, hospices and other specialist palliative care services. I am proud of the considerable improvements that the Scottish Government has put in place, with 14% more doctors and 25% more nurses working to provide specialist palliative care services since 2009. However, I recognise that more and more people are living with long term conditions and many of those who could currently benefit from palliative and end of life care are not receiving it. I am deeply committed to supporting improvements that ensure that high quality palliative and end of life care is available to all who can benefit from it.

In 2014 the World Health Assembly – the governing body of the World Health Organisation - passed a resolution requiring all governments to recognise palliative care and to make provision for it in their national health policies. This Strategic Framework for Action is a response to that call. It builds on many actions and policies already in place and sets out the goals, challenges and direction for future improvement. The Strategic Framework for Action on Palliative and End of Life Care sets out an ambitious, but fully achievable set of commitments that the Scottish Government will work with partners to implement to help ensure that everyone in Scotland gets the care they need when time is becoming shorter.

This Strategic Framework outlines the areas where action needs to be taken to ensure that by 2021 everyone who needs palliative care will have access to it. Building on the work of Living and Dying Well (2008), the Framework will be supported by £3.5 million funding over four years which will be used to drive improvement across the sector and support targeted action on training and education. This will be made possible through the promotion of collaborative working to harness the knowledge, skill and vision of the many extraordinarily passionate individuals who work and volunteer to help those with palliative care needs. Staff from health, care, independent and third sector organisations will be given the support they need to improve the delivery of palliative and end of life care in their sector.

The Framework will also work to drive a new culture of openness about death, dying and bereavement. We will work to support organisations in developing a national conversation which engages with this topic that I fully understand is difficult yet vital to discuss. We will also seek to extend this openness to the appropriate sharing of information to ensure that the people of Scotland experience an integrated health and social care system that fully takes into account their end of life care preferences.

Shona Robison MSP
Cabinet Secretary for Health, Wellbeing & Sport

These are inspiring times for palliative and end of life care in Scotland. This Strategic Framework for Action on Palliative and End of Life Care is published in a year when we have seen unprecedented public discussion about end of life issues – in the Scottish Parliament, in the national media, in expert reports, briefing documents, consultation submissions and in the work of leading researchers.

As a society we are facing a growing need for appropriate care in the face of ageing, life limiting illness and death. We are challenged by the scale and complexity of this - but we have substantial assets and expertise within Scotland with which to respond. The Framework builds on these, to map out a vision where everyone who can benefit from palliative care in Scotland will receive it – no matter what their circumstances.

To achieve this vision, many people, organisations and agencies will have to work together in a culture of collaboration and with a passion for improvement.

We would like to express our gratitude to all those who have contributed to the development of this Strategic Framework for Action. We would especially like to offer our thanks to all of those who have contributed in their capacity as members of the Palliative and End of Life Care National Advisory Group and Stakeholder Group (detailed in Annex C) or through attending one of the three engagement events.

Palliative and end of life care are now issues of major public interest. The Scottish Government has made its commitments clear. The Strategic Framework for Action and accompanying evidence summary lay out the elements in the work we must now do to create a more compassionate Scotland - and to give people the best care we can at the end of their lives.

Professor David Clark
Consulting Editor, Strategic Framework for Action
University of Glasgow

Professor Craig White
Chair, National Advisory Group for Palliative & End of Life Care
Scottish Government