Progress for the Scottish Parliament Inquiry into Palliative Care

The public has responded to a call for views on the state of palliative care in Scotland, and with the publication of these submissions the Scottish Parliament Inquiry into Palliative Care is making rapid progress.

I am struck by two things: the great variety of these responses, but also the rather low volume.  Perhaps that tells us something about the distance palliative care has to travel in order to attract the engagement of a wider spectrum of groups across society.

This is a critically important time for palliative and end of life care in Scotland, with the Scottish Government working on a Strategic Framework for Action on Palliative Care and the Scottish Parliament simultaneously conducting its Inquiry.

Written responses received

The Scottish Parliament Health and Sport Committee published  55 responses to its call for submissions about the state of palliative care in Scotland shortly after a mid-August deadline. The submissions come from a range of individuals and organisations. Some are anonymous and reflect on personal experiences of care. Some come from major specialists in the field. Others emanate from specific parts of the NHS as well as from special interest groups. They give a good overview of the challenges we are facing in developing palliative care in Scotland.

I am not sure about the significance of the low volume of submissions, but it’s worth noting that there were no less than 886 submissions to the same Committee when it took evidence on the Assisted Suicide (Scotland) Bill in 2014.

The wider role of the Health and Sport Committee is ‘to examine the Scottish Government’s health policy, the NHS in Scotland, sport and other matters within its remit’.

The two dominant themes in the Committee’s call for views  on palliative care were equity of access and the timing of discussions and plans for future care:

• equitable access to palliative and end of life care across disease groups and key priorities
• the right time, place and people to begin discussing options for palliative care
• good practise in communication about palliative care and the challenges that remain
• the role of anticipatory care plans and how their uptake can be improved
• making palliative care information more easily available to patients families during
• training and support for staff on discussing palliative care with patients and families, and at the right time
• challenges in recording and documenting  priorities and communicating them between different health and care providers

Public hearings

The next stage in the Inquiry is for the Health and Sport Committee to meet in mid-September, when hearings of oral evidence will commence. I have been asked to produce a briefing document on international comparisons in palliative care provision, to guide the Committee.

During these hearings the Committee is expected to take oral evidence from organisations such as the Royal College of Nursing, Children’s Hospice Association Scotland and the Scottish Partnership for Palliative Care. Further selection of witnesses will be informed by the written evidence received.

These will be public hearings which anyone can apply to attend, and it will also be possible to view them online.

Academic input

My own work for the Committee is to address a set of questions concerning what we know about the use of indicators for palliative care delivery in the international context, particularly for those countries that rank highest in the global research literature.

These indicators include three specific sets of measures concerned with:

1. inputs, resources and provision for palliative care
2. needs for and processes in the delivery of palliative care
3. outcomes of palliative care

It is expected that my advisory work on indicators will be published by the Committee in September 2015.

The Inquiry is expected to report its findings before the end of 2015. In the same timescale Scottish Government will publish its Strategic Framework for Action on Palliative and End of Life Care. I am working with Scottish Government colleagues in the role of Consulting Editor to the Strategic Framework.

These are important times indeed for palliative care in Scotland. It may be the best opportunity we will have to influence the direction of development and to foster improvement, and we must all sit up and take note, and take action where we can.

I encourage you to read each submission to the Inquiry in detail and to view the hearings as well. Please join the discussion by leaving your comments on this blog.

David Clark