Identifying those requiring access to palliative and end of life care

In this short video presentation I discuss what we know about ways to identify people who are in the last year of their life or who might have palliative care needs.

I start by setting out the global context, showing how many people in the world currently die every year, and explaining why this is likely to increase in the coming decades.

Referring to the WHO Global Atlas of Palliative Care at the End of Life, and a recent paper from Professor Irene Higginson‘s group, I describe the current level of need for palliative care around the world, and how can we identify it at a national level.

• How many people need palliative care? A study developing and comparing methods for population-based estimates, Fliss EM Murtagh, Claudia Bausewein, Julia Verne, E Iris Groeneveld, Yvonne E Kaloki,  and Irene J Higginson. Palliative Medicine
  2014, Vol 28(1) 49–58

I explore what this means for Scotland, where deaths may rise from 50,000 a year today to 60,000 each year by late century. On estimate, that would mean that in Scotland 40,000 people who die each year would currently benefit from palliative care of some kind.

I discuss the findings of  recent Scottish studies conducted in  general practice and in hospital. Can we be confident that all these patients have been identified and that their end of life care needs are being addressed?

• How good is primary care at identifying patients who need palliative care? A mixed-methods study. Zheng L, Finucane AM, Oxenham D, McLoughlin P, McCutcheon H, Murray SA.  European Journal of Palliative Care 2013; 20: 216–222.

In our own study of the Imminence of Death among Hospital Inpatients, we showed that almost 1 in 10 patients in hospital on any given day in Scotland will die on that admission.

I examine which screening tools might be most useful in the identification process, drawing on a systematic review by Professor Scott Murray‘s team:

• What tools are available to identify patients with palliative care needs in primary care: a systematic literature review and survey of European practice. Maas EA, Murray SA, Engels Y, Campbell C.  BMJ Supportive and Palliative Care, 2013;3:444-451.

The Scottish Government invited me to give a presentation entitled ‘Identifying those requiring access to palliative care in Scotland’ at the NHSScotland Event 2015 in Glasgow on 23-24 June 2015, as part of two sessions about palliative care entitled Finding Out What Matters When Time Becomes Short.

We produced a video of my presentation, designed to be shown at the event in my absence – the video above is the same presentation, but in a slightly longer form which also describes the global context. Andrew Foster of Heart of England NHS Foundation Trust and the Marsh family generously gave their permission to use Andrew’s photo of Sheila Marsh.

I hope you will find this presentation useful.

Professor David Clark

gla.ac.uk/endoflifestudies

@EndofLifeStudy