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2007 Health Care Service Group Conference
21 December 2006
Carried as Amended

Around 64% of people would choose to die at home if they had a terminal illness and yet a little over 20% actually do so. In fact, 56% of people die in hospital, though that is the preference of only 11% of the population.

Clearly, the healthcare system is failing to meet patients’ wishes in terms of choosing where to die. Healthcare staff are keen to facilitate the goals of the NHS End of Life Care Programme in achieving greater choice through such measures as reducing the number of emergency admissions to acute care for those who have expressed a wish to die at home and reducing the number of patients transferred from care homes to acute care in the last weeks of life.

However, the success of the programme will only be achieved if sufficient emphasis is placed on the training dimension, as many staff report that they do not feel that they have received the appropriate training to help care for people at the end of their lives and broach the difficult subject of where they wish to spend their last days. UNISON has welcomed the extension of the role of healthcare assistants in palliative care providing daily care and comfort to those patients with a terminal cancer. However much of this work has been funded by charities, which whilst welcome, does not meet the needs of all patients suffering from terminal illnesses.

The care and compassion that both patients and their family receive at this time can have a direct impact on their grieving process; it is during this time especially that the whole multi-disciplinary team come together to improve access at home and to facilitate high standards of care.

In addition, this conference notes that current legislation places healthcare professionals in an impossible situation when treating terminally ill patients because of the grey line between administering pain killers legitimately to ease suffering and assisting a patient to die, which can leave staff open to question.

Surveys have found that 82% of the public think that it is unacceptable that people who are suffering unbearably from a terminal illness cannot ask for medical help to die if that is what they want and two-thirds of nurses believe that assisted dying should be legalised. Conference believes that it is time to open up the debate over the right to die.

However, whatever the outcome of that debate, legislation must provide sufficient clarity to ensure that staff no longer suffer from the fear of prosecution when acting compassionately to ease the pain of terminally ill patients.

Therefore, this conference calls on the SGE to:

1.Work in partnership with the Department of Health and the Scottish Executive Health Deparment to ensure the success of the NHS End of Life Care Programme to facilitate greater choice for patients in their place of death, paying particular attention to provision of adequate staffing levels and appropriate training to equip staff with the skills for sensitive end of life care;

2.To work in partnership with the voluntary and community sector to develop closer working relationships with charities working on end of life care;

3.Develop closer local links with hospices and campaign for further funding to facilitate the significant work that they undertake caring for patients of all ages with a terminal illness;

4.Regions to work with the Strategic Health Authority Leads to identify how this work can be achieved and what additional staffing and training will need to be identified to facilitate this. In Scotland that the Region ensure effective implementation of the ‘Delivering Care, Enabling Health’ Strategy;

5.Health branches to make contact with their local community and voluntary groups including hospices to facilitate networking and improve access to the service.