18th November 2017


A Round Up of Palliative Care Developments in Scotland

Living and Dying Well - Scotland’s Palliative and End of Life Action Plan

January 2011 saw the publication of Living and Dying Well: Building on Progress which discusses the progress that has been made in Scotland in relation to the actions and recommendations of Living and Dying Well: A National Approach to Palliative and End of Life Care in Scotland which was published in 2008. The report highlights progress such as:

  • robust on-going governance and leadership to support improvement

  • on-going national roll out of the electronic palliative care summary (ePCS)

  • the publication of the NHS Scotland Do Not Attempt Cardiopulmonary  Resuscitation (DNACPR) policy13

  • the publication of the NHS Scotland Resuscitation Policy for Children and Young People14

  • the commitment and support of organisations including NHS Quality Improvement

  • Scotland, NHS Education for Scotland and the Scottish Partnership for Palliative Care

  • strong links across national strategies and policies including the Healthcare QualityStrategy4

  • the development of palliative care guidelines

  • recommendations on palliative care assessment tools

  • the development of NHSScotland referral criteria to specialist palliative care and

  • publication of guidance on advance care planning.

In addition Building on Progress sets out the Scottish Government’s future priorities for palliative and end of life care which include:

 

  • Continued development of education and training in areas such as communication skills, palliative care for adolescents, DNA CPR and palliative care in care homes.

  • Development of a system for updating and reviewing national symptom management guidelines and use of recently recommended assessment tools, prognostic indicators and dependency measures

  • Use, by NHS Boards, of the newly developed referral to Specialist Palliative Care guidance

  • Further use of advance care plans (ACP) which include the core components of the electronic palliative care summary and SBAR

  • Formal audits of ACP in terms of level of use and outcomes of care

  • Clear organisational structures in all acute hospitals by which to implementLiving and Dying Well recommendations

  • Development, by The Scottish Partnership for Palliative Care, of a national group for palliative care in hospitals

  • Establishment of a broad-based coalition to promote a societal culture of open discussion about death, dying and bereavement

The Living and Dying Well action plan from 2008 can be accessed using the following link:

Living and Dying Well

To read the full Building on Progress document follow the link below:

Building on Progress

Shaping Bereavement Care

Over the last two years a national working group has been developing evidence based guidance on the care of the bereaved. This has culminated in the production of a document entitled “Shaping Bereavement Care:A Framework for Action for Bereavement Care in NHSScotland”. This document is to be launched along with a Chief Executive’s Letter to all Health Boards by the end of February 2011. Once received Boards will have to develop an action plan of how they will meet the Shaping Bereavement Care recommendations by October 2011. Further information on this guidance will be provided in the next edition of our newsletter. 

End of Life Assistance (Scotland) Bill

This Bill was introduced into the Scottish Parliament on 20 January 2010 by Margo MacDonald, the Independent MSP for Lothian. Following this a Parliamentary Committee took both written and oral evidence on the Bill. You can review the correspondence and evidence received about the Bill by following the link below:

Evidence and correspondence received

The IANPC formulated a written response to the Bill and was then asked to give oral evidence to the Committee on the role of nurse’s in assisted suicide. Based on all the evidence presented the Committee then produced a report which concluded:

“Overall, the majority of the Committee was not persuaded that the case had been made to decriminalise the law of homicide as it applies to assisted suicide and voluntary euthanasia, termed ‘end-of-life assistance’ in the Bill, and, accordingly, does not recommend the general principles of the Bill to the Parliament.”

Following this Parliament held its Stage 1 debate on the End of Life Assistance (Scotland) Bill on Wednesday 1 December 2010. The Parliament did not agree to the general principles of the Bill. As a result the Bill fell.

Palliative Care (Scotland) Bill

This Bill was developed to

“require palliative care to be provided to persons with a life-limiting condition and to members of such persons’ families; and to require reports on the provision of palliative care to be made to the Scottish Parliament.”

This meant that there would be a legal duty for The Scottish Parliament to ensure the provision palliative care to all dying people and their families. The Bill was introduced in June 2010 by Gill Paterson, Scottish Nationalist MSP for The West of Scotland. Evidence was presented to the Bill Committee in both writing and orally in the autumn of 2010. Based on the evidence presented the Committee reported that it:

“understands the motivation of the member in charge in introducing the Palliative Care (Scotland) Bill and shares his desire to drive forward improvements to the delivery of palliative care. The introduction of the Bill has stimulated a very important debate about the future of palliative care services in Scotland.”

However the committee concluded that:

“an unintended consequence of passing the Bill could be that the focus and progress on delivery of Living and Dying Wellmight be lost……(and) that by placing on Scottish Ministers a specific statutory duty to provide palliative care, rigidly defined in primary legislation, flexibility of service provision may be lost.”

The majority of the Committee did not recommend that the Parliament agreed with the general principles of the Bill. Based on the Stage 1 report Gil Paterson withdrew the Bill in December 2010 and as such it will not proceed any further. 

CME McKinley (c) 2010 Independent Association of Nurses in Palliative Care