Palliative Care Matters for All: palliative care strategy 2025 to 2030

About Palliative Care

What is palliative care?

Palliative care focuses on what matters to people. For people of all ages that means living as well as possible with life shortening conditions. Palliative care goes beyond treating health conditions to supporting each person and their family and carers to maintain quality of life, wellbeing and independence.

Palliative care is holistic care of a person of any age living with life shortening conditions and their family and carers that focuses on what matters to them.

Palliative care helps people with pain and other symptoms, emotional, psychological, social or financial problems, and spiritual wellbeing regardless of faith or belief.

Palliative care can start from around the time of diagnosis of a new life shortening condition as well as being important when someone’s health is declining.

Life shortening conditions mean a person’s health will deteriorate and, at some point in the future, they will die with those conditions. These changes in health and wellbeing are unpredictable. What will happen to each person and when is often uncertain. Increasing health or care needs at home, having to use urgent care services or an emergency hospital admission are signs it is time to consider adding palliative care to other treatments or as the main approach to care.

Palliative care is much more than care of people who are dying. This misunderstanding can mean people of all ages with different life shortening conditions miss out on palliative care and wider support that should be offered earlier. Treatments for these conditions may prolong life, but it is important for people to receive palliative care as well. Starting palliative care does not mean stopping treatments that are working now or could help in the future. People can continue to receive treatments for their health conditions with palliative care.

Many inequalities continue to affect the care and support people need and receive across Scotland. These can be due to factors such as where a person lives, health conditions like mental illness, being in prison, disabilities including learning disabilities, neurodiversity, poverty, language or communication barriers, culture, faith or belief, age, sex, gender, sexual orientation or personal circumstances. Inclusive, flexible and person-centred palliative care means taking steps to address inequalities and inequities experienced by people of all ages with life shortening conditions and their families and carers in delivery of all our outcomes.

Care around dying

Palliative care may start around diagnosis of a life shortening condition but also includes care of a dying person of any age and their family and carers. Health and social care staff and teams need to be able to recognise when someone is dying and talk with them and the people close to them about what is happening. When someone is dying the focus of treatment and care changes to reflect what matters now. Family, carers and others close to the person are included and supported.

Care around dying is holistic care of a person of any age who is dying that focuses on their comfort and includes people close to them.

Care around dying is given in the last hours, days or few weeks of a person’s life and includes care after their death.

Care around dying involves and supports family, carers and other people close to the person throughout this time and when they are bereaved.

Who provides palliative care?

People of all ages living with life shortening conditions spend most of their time living at home supported by their own networks of families, friends and neighbours, local communities, volunteers, and different support groups. Support for carers is essential.

Integration Authorities are responsible for planning and resourcing adult palliative care in their communities and hospitals. Palliative care is provided across the NHS, by local authorities, independent hospices, and other third-sector organisations. Care homes and care at home services are other independent providers of palliative care.

General palliative care for adults is provided by many health and social care staff as part of their care for people with life shortening conditions in all places of care. Some have additional training or qualifications in palliative care. All staff and students need relevant training in palliative care in line with the NHS Education for Scotland/Scottish Social Services Council Palliative Care Education Framework.

Adult specialist palliative care services are provided by multidisciplinary teams with specific expertise and specialist training. All Health and Social Care Partnerships have access to community specialist palliative care services, and most Health Boards have hospital specialist palliative care teams. In Scotland there are 14 independent hospices serving 7 Health Board areas, and 7 NHS specialist palliative care units or hospices serving 8 Health Board areas.

Palliative care for children is provided by Health Boards, local authorities, Integration Authorities, and third sector organisations in all places of care, including within community children’s services. Children’s Hospices Across Scotland (CHAS) provides specialist paediatric palliative care services from two hospices, and a community service. CHAS collaborates with NHS Boards to provide specialist services in hospital and at home, including through shared posts.