TENS of thousands of Scots might be missing out on good end-of-life care due to unequal access to services, a report suggested yesterday.
Audit Scotland estimated that 42,000 patients a year could benefit from some form of palliative care to help them cope with distressing symptoms and anxiety in the last days, weeks and months of their lives.
But they found that only 5,000 patients
with potential palliative care needs were identified and recorded by their GP, meaning the rest may be at risk of not getting help when needed.
Campaigners said the findings highlighted the need to ensure people had good support at the end of their life for symptoms such as
pain, breathlessness, anxiety and depression.
Audit Scotland said access to palliative care needed to improve and be provided more consistently across the country.
It pointed out that about 90 per cent of specialist palliative care – such as that provided by hospices and special hospital wards – was delivered to patients with cancer, although cancer accounted for less than 30 per cent of deaths.
Audit Scotland said more needed to be done to improve care for patients with other serious conditions, such as dementia and motor neurone disease.
Around 55,000 people a year die in Scotland – three-quarters of whom it is estimated would benefit from some kind of care in their final days. But Audit Scotland said that, judging by those listed on GP palliative care registers, only around 12 per cent of patients needing this care were being identified.
"There is a risk that failing to recognise when a patient could benefit from palliative care may result in a patient not getting appropriate care in the community or not being referred to specialist care when this is needed," the report said.
Roddy Ferguson, one of the report's authors, said registering patients as in need of palliative services was the best way to ensure the highest level of care.
"Patients not on the register may still be getting some care, but by being on the register you have your full palliative needs assessed and a co-ordinated plan put in place," he said.
"The difficulty is often recognising when palliative care is required."
Audit Scotland also found that access to palliative care varied widely around the country.
"There is significant variation across Scotland in the availability of specialist palliative care services and how easily patients with complex needs can access these," the report said.
And, overall, the auditors found that services were hardest to get in remote and rural areas.
Audit Scotland said guidance on pain medication needed to be followed and also highlighted gaps in the psychological, social and spiritual support given to patients in Scotland, as well as a lack of respite for carers.
It also pointed out that the cost of providing palliative care was likely to increase with the ageing population.
Maggie White, from Marie Curie Cancer Care in Scotland, said the report showed the main limitations in palliative care and the need for improvement.
The full article contains 517 words and appears in The Scotsman newspaper.
