Highland Hospice head of hospice services calls for Scottish Government to make pioneering end-of-life care partnership with Scottish Ambulance Service a permanent thing
A pioneering Highland initiative which is helping people receive end-of-life care at home while also freeing up A&E beds should be made permanent, a hospice head believes.
The Highland Hospice and the Scottish Ambulance Service (SAS)are among several bodies currently taking part in the End of Life Care Together scheme in the north.
This pilot project, which is currently only funded until the spring, sees paramedics given training to provide symptom relief to a dying person in their own home or care home rather than immediately taking them to A&E - avoiding the need for hospital admissions and the use of hospital beds, while also helping the patient avoid unnecessary stress in their final hours or days.t
Currently the Scottish Ambulance Service is called out to around 50,000 end-of-life care incidents across Scotland every year - around seven per cent of its entire annual workload.
Advocates of the pioneering scheme argue that this means that many people thousands of people approaching the end of their lives can spend their final hours waiting for admission in A&E or stuck in side room hospital beds away from their loved ones - rather than in a less stressful setting of their own choosing with friends and family present.
Highland Hospice’s head of hospice services Paula Cooper, speaking on BBC Scotland's Lunchtime Live show recently, explained that taking people to hospital can be “very stressful” for them and very upsetting, adding; “I think the best thing is for people to be treated where they want to be treated - and that's often at home.”
Ms Cooper explained that their palliative care helpline may identify people who are requiring symptom management, and that under the Highland project “then we can contact the SAS who can attend and through joint decision making administer the symptom relief”.
She added: “It means that people can remain in their own homes. We know that there are people often within the hospital situation where they don't need to be there... or more importantly they don't want to be there.”
And she has urged the Scottish Government to make such initiatives permanent. Holyrood is currently consulting on a new strategy for palliative care, and Ms Cooke has urged it to make this scheme part of that.
“It's proven to be beneficial,” she said. “I can only speak for Highland where we have worked very closely with the ambulance service, but given the feedback that we're having, and seen the results that we're seeing, then if this was permanent then I think people would be far better placed… people at end-of-life care would know that there is a service that they could receive and benefit from, so yes I would certainly urge that.”
She added that the current end of government funding for the project was a cause for concern “on several levels” - citing the patients’ personal needs and wishes, as well as the extra pressure unnecessary A&E admissions place on the availability of acute hospital beds.
“From our perspective, it really is trying to make sure that people get the right care, in the right place at the right time.”
Scott Mackinnon, an advance paramedic with the Scottish Ambulance Service who has been leading the project, also stressed the benefits during the same BBC interview..
He said: “We're often hearing that, as a result of this pathway, we are actually able to admit this patient directly to a hospice and their family were able to come along with them and they subsequently died within a short space of time after admission.
“Whereas before, that could have potentially been that ambulance crew transporting [them] to an emergency department, and no beds and possibly dying in a side room alone.”
