Marie Curie calls for ‘around the clock’ care for terminally ill in Scotland

Less than half of GPs believe the majority of their patients’ pain is relieved all the time

Terminally ill people are not getting access to the right care when they need it, according to a new survey commissioned by Marie Curie with Doctors.net.uk¹. The survey, which reflects the views of 1,000 GPs across the UK, also reveals family doctors’ concerns about supporting patients being cared for at home.

The survey of 1,000 GPs across the UK reveals that less than half (47 per cent) of GPs in Scotland believe that their terminally ill patients receive adequate access to care at night and at weekends.

The issue surrounding around the clock care was also highlighted in a new report published by Marie Curie today, called ‘Difficult Conversations with Dying People and their Families’². Families reported having to chase after prescriptions, nurses waiting hours for vital drugs to arrive, and locums unable to prescribe.

Other key findings from the survey of GPs (of which 100 were based in Scotland), include:

• A third of GPs in Scotland (31%) believe their terminally ill patients do not get adequate access to specialist palliative care nursing.
• Of those Scottish GPs who do not feel patients get adequate access to pain control at home, nearly nine out of ten (88%) said more training and support about pain control in palliative care would make a difference and three quarters (75%) rated access to 24/7 specialist palliative care rapid response teams** as a key answer to improving this.
• When asked to indicate factors that are likely to reduce quality of pain control, almost one in two (44%) Scottish GPs opted for lack of anticipatory* (just in case) prescribing, over half (55%) expressed concern about over prescribing medication; nearly a quarter (23%) considered poor availability of palliative care services and nearly a third (32%) cited poor availability of pain relief out of hours as the determining issues.

Richard Meade, Head of Policy & Public Affairs for Marie Curie in Scotland, said: “Everyone is telling us – from GPs, families and carers – that more needs to be done to improve access to specialist palliative care and pain control at home.
 
“We know that effective pain management at home is an important factor that influences whether someone has a 'good death', and we only have one chance to get it right.
 
“Terminally ill people and their families in Scotland need timely access to care and pain relief around the clock. At the moment two thirds of this time is considered to be ‘out of hours’ by the healthcare system.
 
“With only 17% of terminally people at home having their pain relieved completely³, it is vital that healthcare professionals are available to terminally ill people around the clock and that they are equipped to provide pain relief.”

Nichola Summers, Divisional General Manager of Marie Curie in Scotland, said: “Here in Scotland, GPs and primary care teams are best placed to ensure effective co-ordination of palliative care but if terminally ill patients are to get the reliable, high quality care they need at home, NHS, social services and voluntary sector professionals all have their part to play.
 
“Our ageing population has increasingly complex and diverse needs, so it’s important that GPs are equipped and supported in this work. Our partnership work with the Royal College of General Practitioners is one way we are tackling this, but much more is needed.”

Richard Meade added: “Terminally ill people should not be spending their last precious weeks and days with their families in unnecessary pain because the system moves too slowly.
 
“This is why we are calling on care providers to do more to ensure that 24/7 care is universally accessible for all terminally ill people and their families, no matter where they live in Scotland.”

-ENDS-

References

^{1. The survey was commissioned by Marie Curie with Doctors.net.uk (DNUK) and conducted by DNUK’s research division medeConnect Healthcare Insight. Respondents were recruited from the Doctors.net.uk membership. Responses were collected from 1003 regionally representative GPs in the UK. The survey fieldwork was conducted over the period 22-28 January 2014.↩}

^{2. ‘Difficult Conversations with Dying People and their Families’- Report, March 2014↩}

^{3. National Bereavement Survey (VOICES) 2012 ↩}