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MSPs warned of gaps in training for palliative care referral

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Better palliative care training is required for nurses and other healthcare professionals working in both specialist and general roles in Scotland, MSPs have been warned.

Experts said improved use of screening tools and a greater understanding of what palliative services provide were needed.

At the first evidence session as part of Scottish Parliament’s health committee inquiry into palliative care, MSPs were also told barriers to providing appropriate care stemmed from a lack of open and honest conversations across society about palliative care.

“We need to make sure there is enough training and education not just for specialists in palliative care but for generalists and different specialisms”

Richard Meade

Richard Meade, head of policy and public affairs for Scotland at charity Marie Curie, said: “In terms of barriers, we need to make sure there is enough training and education not just for specialists in palliative care but for generalists – that’s GPs, district nurses and consultants in hospitals - and different specialisms to make sure they understand how to link in with palliative care.”

He added: “Sometimes it’s just the start of conversation and actually when somebody is seriously ill there is a point at which someone approaches them and talks to them about that condition and what matters to them.”

When asked by Scottish National Party MSP  Dennis Robertson whose responsibility it was to identify the time at which palliative care was required, Trisha Hatt, development manager at Macmillan Cancer Support, said it was important to “upskill generalist staff” so a wide range of professionals could recognise the patient’s need for palliative care.

Marie Curie’s Mr Meade later added there was a range of screening tools available for identifying the need for palliative care but that staff needed training and support to use them.

However, Maria McGill, chief executive of Children’s Hospice Association Scotland who also gave evidence, noted there were less tools for screening children and that more research was required to develop them.

“For children’s palliative care it’s really important all health and social care professionals have an awareness of what palliative care can bring”

Maria McGill

She also highlighted that health and social care professionals who refer children to specialist palliative services required a greater understanding of what they offer.

“For children’s palliative care it’s really important all health and social care professionals have an awareness of what palliative care can bring,” said Ms McGill.

“Referral to palliative care services for a child with a life shortening condition does not mean the end of a curative treatment.

“It simply means that child and family have access to a life enriching experience and to professionals who are perhaps better able to manage symptoms and who have the time to understand what matters to them,” she said.

Meanwhile, all experts noted a lack of data around the number of people who have conditions other than cancer that typically require palliative care, such as dementia, as well as an absence of routine collection of information on those who do receive this type of care.

The Health and Sport Committee set up its inquiry – called We need to talk about Palliative Care – to find out the barriers to accessing palliative care as well as problems around conversations between healthcare professionals, patients and families.

It has also agreed to carry out research to compare international measurements of data around palliative and end of life care.

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