MOST health boards in Scotland are failing to provide special support for dying patients who are dying during evenings and weekends, an investigation has found.
Just one out of 15 health authorities provides a “comprehensive service” out of hours for dying patients and families to turn to from home, according to the research by hospice charity Sue Ryder.
The charity says its their survey found nine health boards, including NHS Greater Glasgow and Clyde, do not provide “any meaningful 24/7 support for people who are dying and their family and carers”.
Meanwhile Others have dedicated helplines staffed by nurses who are experts in palliative care.
The charity unveiled itstheir findings as new figures were released showing how much time people in Scotland spend at home – rather than in hospital – during the last six months of their lives. The data was expected to show little improvement in the amount of time people are able to spend at home Pamela Mackenzie, director of Sue Ryder in Scotland, said: “Imagine, if you are looking after your loved one in their final weeks and at 3am one night, they suddenly become distressed and struggle to breathe.
“Rather than calling 999 or NHS24, if you can speak to someone who specialises in palliative care and ideally knows your family member’s history and wishes, they will give you appropriate advice.
“This means you can try to keep your loved one at home rather than being admitted to hospital as an emergency and all the stress that this would entail.”
“This isn’t only better for the family whose wishes will be more likely to be met, but it means a stay in a costly hospital bed is avoided.“ A national action plan for end-of-life care was launched in Scotland in 2008.
It highlighted concern about the way dying patients accessed healthcare when GP surgeries were shut.
Last year, a review of out-of-hours care commissioned by the Scottish Government concluded: “People at the end of life and their carers should be able to directly access care and assistance, by local helpline on a 24/7 basis, without recourse to national NHS 24 triage.”
Using Freedom of Information legislation, Sue Ryder asked all Scottish health boards if they provided expert palliative care advice by phone and via the internet 24/7.
It found that only Lanarkshire provided a comprehensive service around the clock.
Lothian, Ayrshire and Arran, Forth Valley, Grampian and Highland, excluding Argyll and Bute, provided a partial service. This meant, for example, there was phone or online help, or the service was limited to those people known to hospices.
The other authorities are described as not providing any meaningful support on a 24/7 basis.
Ms Mackenzie said: “We all know that dying isn’t restricted to the hours of 9-5 and, indeed, some of the darkest times for people facing the end of life and their families are overnight.”
In England, the Sue Ryder charity provides a service in Yorkshire which gives patients a single point of contact for concerns. The phone line staff can help with medication and send out district nurses and GPs to see patients. Staff estimate it has helped avoid 189 hospital admissions in a year.
The charity is calling on Scotland to improve its out of hours services for people who are dying.
A Scottish Government spokeswoman said: “We look forward to working with Sue Ryder and others to support the implementation of the national commitments to ensure that by 2021 – supported by £3.5 million over the next four years – everyone in Scotland who needs palliative care will have access to it.
“The implementation of this strategy is in its first year.
“A number of NHS boards provide support, including Fife and Greater Glasgow, both of which have 24/7 ‘fast track’ support services, operated by and with Marie Curie.
“Community nursing teams in Shetland also offer a 365-days-a-year service for patients dying at home.”Alison Johnstone MSP, Health & Social Care spokesperson for the Scottish Greens, today commented on new figures showing no increase in the time spent at home rather than in hospital in the final six months of life. Health care charity Sue Ryder has also revealed that only one of Scotland’s 14 health boards provides a comprehensive out-of-hours service for people who are dying. Alison Johnstone MSP said: “With our ageing population and increasingly complex medical conditions, it’s important that we strive to give people who are dying the choice to spend their final days at home rather than in hospital. This means a really joined up approach to our health and social care system. “The figures released today suggest the need for a greater effort from Government and health boards to make the option of palliative care at home a realistic one for more people.
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