Public Audit Committee, 04 Nov 2009

Meeting date: Wednesday, November 4, 2009

Official Report 160KB pdf

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Palliative Care Action Plans

I invite the Auditor General to provide us with an update on palliative care action plans.

With your agreement, convener, I invite Angela Canning to take you through that.

Audit Scotland published a report on palliative care in August 2008, and the committee subsequently published its report in January this year.

The committee's report asked for an update from Audit Scotland on national health service boards' local delivery plans in relation to "Living and Dying Well: A national action plan for palliative and end of life care in Scotland", which the Scottish Government published in October 2008.

Our general observations are that, since the Audit Scotland team first started to examine palliative care, a lot of work has been done across Scotland, at local and national levels, to improve services. Scrutiny by Audit Scotland and the Public Audit Committee has raised the profile of this important service and has contributed to developments that are aimed at improving it.

The local delivery plans cover the 11 actions for boards that are set out in "Living and Dying Well", plus one of Audit Scotland's recommendations that was not addressed in that document, which is that boards should work with the voluntary sector to put in place commissioning and monitoring arrangements to ensure that value for money is achieved.

The Audit Scotland team considers that the Scottish Government went through a robust process to support boards in developing their local delivery plans. The Government issued a template that required health boards to identify actions against all the relevant actions in "Living and Dying Well". A review group assessed the plans against a number of criteria, such as ensuring that they cover patients in all care settings and with all conditions, not just cancer. That means that each board has a plan that covers all the actions and is intended to promote equal access to palliative care for all who need it.

Audit Scotland was invited to be present during the review process, and staff attended a meeting at which all the local plans were reviewed. The Scottish Government is continuing to monitor boards' progress and received updates from the boards at the start of October this year.

Our briefing paper for today's meeting also gives an update on other work that is relevant to the recommendations in the committee's report but which is not included in the boards' delivery plans, such as work that is being done on consistent national data collection, progress towards developing a national do-not-attempt-resuscitation policy, revised guidance on funding voluntary organisations and the work of several short-life working groups.

In summary, a lot of work is happening in relation to improving palliative care services. That will need to be evaluated in the future to ensure that all of that activity leads to real change and improvements for people. We will be keeping a watching brief on that.

There has been welcome progress. What you report is commendable, and I am delighted that the Government, ministers and officials are taking the issue seriously. Any improvement that we can make in the service that is provided to people who are at this sensitive stage in their lives is to be commended. I am delighted to hear what you have to say about the progress that is being made.

I agree with what you have said, convener. However, a number of pieces of information are due to be delivered. I see that the advisory group on "Living and Dying Well" is due to report in December and that there are two short-life working groups that are due to report in December. It would be useful if we could see those responses and reports when they are available, and perhaps do a follow-up thereafter.

Do members agree to note the report and return to the issue at a later date?

Members indicated agreement.