Integrating lived experiences of out-of-hours health services for people with palliative and end-of-life care needs with national datasets for people dying in Scotland in 2016: a mixed methods, multi-stage design

This episode features Professor Scott Murray (Primary Palliative Care Research Group, University of Edinburgh, Scotland, UK).

People living at home with advanced progressive illness require well-coordinated services at all times of the day and night. Early identification for generalist palliative care support and care planning in the community can improve outcomes but requires effective information sharing across services. People with palliative care needs are high users of unscheduled care in the last months of life.

People dying with advanced organ failure accessed unscheduled community health services less often than people with cancer or frailty. The organisation of unscheduled healthcare services is poorly understood, and current care pathways could be used more effectively in line with patient preferences. Early identification and care planning in primary care of those requiring palliative care informs and enhances their urgent and emergency care

Better resourcing of unscheduled community services for people identified for palliative care support in the community will provide safer, more responsive, and cost-effective care. Rapid access to unscheduled care via effective NHS telephone services and out-of-hours primary care assessment can reduce unwarranted ambulance calls, attendances at emergency departments and hospital admissions. Public education should encourage and support patients and carers living with advanced illness to access the unscheduled care best suited to their needs. Routine clinical datasets for most NHS unscheduled care services lack a variable to record patients in the community identified for palliative care.