Article Text

Download PDFPDF

P-09 End of life care together- population approach to palliative end of life care in Scotland
  1. Michael Loynd1,
  2. Sian Marchant2 and
  3. Lorien Cameron-Ross1
  1. 1NHS Highland, Inverness, UK
  2. 2Highland Hospice, Inverness, UK


Background End of Life Care Together (EoLCT) is a partnership approach delivering outcomes that matter to people with Palliative End of Life Care (PEOLC) needs. Through this realistic medicine population value approach there is an aim to move from reactive to proactive service approaches promoting increased resource in community settings.

Aims Through this approach there is a triple value aim:

  1. To individuals by prioritising the outcomes that matter to them.

  2. To the wider community providing equity of access to services.

  3. In the way collective resource is assigned and allocated to this population (Thomas & Gray, 2018. Br J Gen Pract. 68:116).

Methods To achieve these aims a whole system approach is required. Key areas were identified with their own objectives:

  • Identification and shared planning.

  • Primary care partnership.

  • 24/7 co-ordination.

  • Communication and engagement.

  • Evaluation.

Overarching this is a Leadership Group with strategic partners and an Oversight Group with key stakeholders.

Results 15% of NHS budgets are spent on PEoLC. With 75% of spend in secondary care majoritively on unscheduled admissions (North East Essex Health and Wellbeing Alliance, 2020). While in-patient care is a necessary it is evidenced that this could be reduced by up to 40% (Hawksworth, 2017). People at end of life generally want to remain at home for as long as possible. EoLCT is optimising and coordinating delivery of community services to increase the likelihood of people remaining in this setting (Gomes, Calanzani, Curiale, et al., 2013. Cochrane Libr. 6).

Conclusions EoLCT is leading a multi-partner value-based population approach bringing together the public and third sectors with a clear vision. Multi-agency approaches have been well advocated in key national reports and strategies (National Services Scotland, 2019; National Services Scotland, 2021; Scottish Government, 2021). The EoLCT partnership aim to demonstrate that this approach will ensure equitable, sustainable and transparent resource use that achieves better outcomes and experiences for individuals, professionals and the population (Hurst, Mahtani, Pluddemann, et al., 2019. CEBM report).

How innovative or of interest is the abstract?Provides an exemplar of a population approach delivered through NHS/hospice.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.