Thank you very much. I have a brief opening statement.
I appreciate the opportunity to support the committee’s interest in palliative and end-of-life care. It is a sensitive subject; we are talking about how we care for people at the end of their lives, so we will treat the committee’s questions sensitively. If there is anything that we do not know but can provide, we will certainly do so as quickly as possible, to assist the committee.
I recognise that end-of-life care is not provided by the national health service alone. We greatly welcome the contribution of partner organisations, voluntary services and others, from which many have benefited.
Palliative care is a key dimension of high-quality care and services for people in Scotland who have progressive incurable conditions. A 2008 Audit Scotland review highlighted several areas in which focused action and improvement were required, and the publication in 2008 of the “Living and Dying Well” action plan provided everyone working in palliative care with a clear description of the required changes. Several improvements in education, national information systems, a single national policy for decision making on resuscitation, and the development of a set of national indicators were among the significant developments that came about as a result of that action plan, and were reflected in progress reports published in 2011 and 2012.
We are progressing plans to publish a new strategic framework, which will guide us, focus on the actions that will be needed to sustain the changes that have been made, and accelerate the pace and scale of improvement where that is needed.
The quality strategy measurement framework included a measure of the percentage of people spending six months at the end of life at home. The data have shown increases over time, but the increases are small. The data are now reported by hospital and health board, and across deprivation categories. We expect our strategic framework for action to outline the future requirements for an enhanced measurement framework, which we believe is important to support improvement.
That said, an increasing number of people’s palliative care needs are now recognised and recorded on registers that are held by general practitioner surgeries. In 2008-09, 7,703 patients’ palliative care needs were recorded; that figure rose to 12,050 in 2013-14. There has been a significant increase in the number of specialist palliative care nurses and doctors working in NHS Scotland in recent years and we now have a single, nationally agreed set of clinical guidelines for palliative care. We have learned from the successes of our national safety and person-centred improvement programmes. We have a new advisory group in place, with more effective links with GPs, hospice chief executives, nurses, palliative care specialists and the leadership of NHS boards, local authorities and national scrutiny and improvement organisations.
Earlier this year some of us met Kate Granger and her husband. All of you will be familiar with the hello my name is programme that Kate set up with her husband. Kate describes herself as a wife, daughter, sister, aunty, friend, doctor and terminally ill cancer patient.
Listening to Kate and her husband speak passionately about their campaign to improve the patient experience in hospital through getting the clinician and patient introduction right was hugely important to me. Indeed, that is one of the most important discussions that I have been part of since I took on my role. It is important that we work collectively to continue to build on what we have done during the past few years and drive forward further improvement. I welcome the committee’s inquiry to that end.