More GPs support the right to have full care at home for patient’s last few days of life

More GPs from throughout Scotland have come forward to support the right to have full care at home for a patient’s last few days of life.

Shetland GP Susan Bowie raised her concerns about the gap in ‘hospital at home care’ for such patients with Highlands and Islands Labour MSP David Stewart and has now received reports from other concerned doctors from out with the area.

She has passed on the anonymised reports to Mr Stewart, also the Scottish Party’s Shadow Public Health Minister, whose Scottish Parliament motion for debate on the issue has now received cross-party support.

One GP explained: “What you are describing has been the status quo here for so long that people no longer expect to die at home and choose the community hospital because they are afraid of the lack of support at home. We do occasionally achieve a well-supported death at home, but usually because of extraordinary family commitment.”

Another wrote that home palliative care is practically impossible, and a lack of overnight care meant a patient was admitted to hospice. Although that care was good, it was not what the patient or the family had wanted.

  • Photo shows Dr Bowie with David Stewart

Mr Stewart said: “This affects many patients and families across the country and I am delighted that other MSPs have now supported the debate on this important subject.

“I know that constituents have been lobbying other Parties to add to the debate and it’s not too late for other MSPs to sign up.”

Shetland GP Susan Bowie has also received the support of Mr Stewart’s Highlands and Islands Labour MSP colleague, Rhoda Grant.

The GP and the MSPs say there should be an automatic right for people to have full care at home day or night for their last few days of life, so that then can have their wish fulfilled to die at home.

Dr Bowie is contesting information from NHS Shetland which states that there are currently carers and nurses available during the daytime, at weekends and evenings who do support people to die at home and nurses are also on call overnight.

The GP said: “Shetland patients dying at home don’t have access to overnight carers, and there is only one District Nurse for the whole of the mainland, and they can’t be there all night with a patient. There is also no cover at short notice at weekends.”

Simon Boker Ingram, NHS Shetland’s Interim Chief Executive, said that figures from ISD Scotland (Information Services Division) show that in 2018/19 Shetland had a percentage of 94% of time in the last six months of life spent at home or in a community setting – the highest percentage of anywhere in Scotland, and consistently the highest percentage in Scotland since 2013/14.

But Mrs Grant added: “Although the figures look good, you can’t get away from the fact that this isn’t reflected by the experience of GPs who are dealing with patients day-to-day. We need to ensure that this gap is filled, not only in Shetland but elsewhere.”

Mr Boker Ingram said that the health board and integration joint board recognise the desire for a more comprehensive offer of health and social care provision across the islands, providing more choice to people including end of life care and there was work underway to achieve this as part of the action plan.

Mr Stewart will be asking for a date for the debate to take place.

 Motion S5M-19252: David Stewart, Highlands and Islands, Scottish Labour, Date Lodged: 03/10/2019

Right to Full Care to Die at Home

That the Parliament understands that 70% of the population in Scotland wish to die at home; notes that many Highlands and Islands-based GPs are trained in palliative care that can support those who wish to die at home; believes however that not all areas of the region have charities or carers who provide “hospital at home care”, especially overnight, and notes the calls for there to be an automatic right for people to have full care at home day or night for their last few days of life, so that then can have their wish fulfilled by being able to die at home with suitable palliative care.

Supported by: Patrick Harvie, Mark McDonald, Claudia Beamish, Neil Findlay, Rhoda Grant, Edward Mountain, Colin Smyth, Alasdair Allan

Current Status: Achieved Cross Party Support