Palliative care access is patchy across Scotland - so concludes a report by Audit Scotland published today. Most Scots are cared for by generalist staff, such as GPs and district nurse, but people with any terminal condition, including those with non-cancerous diagnoses, who need care from specialist services, such as palliative care consultants and hospices, should be able to access it.

Varying standards

Currently there is wide variation across Scotland in the availability of specialist palliative care services; and there are various different models of care provision across the country.

More than 55,000 people die in Scotland each year. Palliative care should be an integral part of the support given to patients and their families and carers during the last months, days and hours of their lives...In many areas of Scotland the voluntary sector and the health service provide excellent and much appreciated care. But access to good quality palliative care varies across the country. The Scottish Government needs to address these issues in the palliative care action plan it is due to publish this October (Caroline Gardner, Deputy Auditor General)

The report also concludes that generalists providing palliative care need access to specialists for support and guidance in order to provide gold-standard palliative care.

Unknown costs

Audit Scotland conclude that the cost of providing palliative care is unknown. However, it is known that in 2006-07 almost £60 million was spent on specialist palliative care, with around half of this sum being raised in the voluntary sector. Generalist palliative care costs are even more difficult to calculate but it is acknolwedged to be a large part of primary care professionals' work load.