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Levels of specialist palliative care services in Scotland rank consistently in the top 10 across Europe, a study by the University of Glasgow has found.

The study reveals the provision of specialist palliative care services in Scotland and compares levels of coverage with other European Union countries to outline gaps and areas for improvement in Scotland’s palliative care provision.

The results, published today in BMJ Supportive and Palliative Care, show for the first time how Scotland fares in its provision of three types of specialist palliative care (SPC) service: inpatient units, hospital support teams and home care teams.

The University of Glasgow team analysed data from the recent Scottish Atlas of Palliative Care and compared it with data from the European Atlas of Palliative Care. Published in 2016, the Scottish Atlas of Palliative Care unlocked the possibility of benchmarking Scotland’s provision against other EU countries. Scottish data had previously been encompassed within UK data.

Scotland was found to have a total of 23 SPC inpatient units containing 349 beds, 27 SPC hospital support teams and 38 SPC home care teams.

Relative to other EU countries, Scotland ranked seventh for provision of SPC inpatient units and hospital support teams, and fifth for home care teams.

The objective of the second part of the study was to place coverage of Scotland’s specialist palliative care services in relation to an ideal 100% ‘gold standard’ set by the European Association for Palliative Care. Coverage for these services was 85% for inpatient units, 100% for hospital support teams and 72% for home care teams.

David Clark, Professor of Medical Sociology at the University of Glasgow, 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.

“I hope that the paper will spark further discussion and will be of use to the unfolding work of meeting the commitments laid out in the Scottish Government’s Strategic Framework for Action on Palliative and End of Life Care.”

This work responds to a commitment in the 2016 Strategic Framework for Action in Palliative and End of Life Care, a Scottish Government publication which in turn was a response to the World Health Assembly resolution in 2014 which requires all governments to recognise palliative care and to make provision for it in their national health policies.

National policy in Scotland has focused on the delivery of palliative care at home or in a home-like setting. The results of this study support a focus on developing specialist palliative care services in community settings to meet Scotland’s policy ambitions.

Aileen Campbell, Minister for Public Health and Sport, 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, Marie Curie Head of Policy and Public Affairs 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.”

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First published: 2 August 2017