MSP David Green urges government to fund Highland Hospice palliative care at home expansion after NHS block

Far North MSP David Green has called on the Scottish Government to invest £1 million a year so Highland Hospice’s care at home service can be introduced across the Highlands after the local health board said it could not fund the programme.

The End of Life Care Together partnership between Highland Hospice and NHS Highland runs a Palliative Care Response Service and 24/7 helpline, which support people to be cared for at home towards the end of their lives.

The initiative has already saved around 6500 hospital bed days, and people who receive responsive care at home spend on average 15 fewer days in hospital at the end of their lives.

Scaled-up across the Highlands, the Hospice estimates that the model could save £6 million a year but while funding from the Social Care Transformation Fund was agreed in principle, commissioning never followed.

Highland Hospice has spent around £400,000 of charitable donation money to keep the service running but now it has been told by NHS Highland that there is no mechanism to fund the service in the future. 

Speaking in Holyrood, Mr Green said: “In the Highlands, long distances mean that hospice care at home is all too often a postcode lottery” while arguing that the Highland Hospice has a "model that works for families and for our health service.” 

The Caithness, Sutherland and Ross MSP told the chamber:  "This is really urgent. Four in 10 people in the Highlands who were referred for extra care at home in the last three months of life received none before they died.

“The Highland Hospice board has now committed a further £1 million of its own reserves to test hospice at home in our most rural communities, including many of those that I represent in the far north. The charity is showing real ambition, but we need the public sector to match it.

"I put on record that I am incredibly grateful to the Cabinet Secretary for Health and Care, who has agreed to visit Highland Hospice. I ask the Government to help to break the deadlock that we have come to.

“We are seeking that £1 million investment to test hospice at home and extend it across the Highlands. Highland Hospice does great work, so I would welcome the minister’s reflections on that and on whether she is willing to meet NHS Highlandand Highland Hospice to try to break that deadlock."

Responding at the conclusion of the debate, Minister for Community Care Alison Thewliss MSP noted the exceptional work done by the Hospice and committed to working with them and David Green MSP to find a viable solution.

Following the debate, Mr Green said: “If we don’t fix the crisis in social care, we won’t fix the crisis in our NHS.

“I therefore welcome the Cabinet Secretary’s commitment to visiting HighlandHospice and seeing the excellent work it is doing first-hand.

“Investing in Highland Hospice is a compassionate choice that will help reduce delayed discharge, free up hospital capacity and ensure more people receive the care they want, where they want it.”

He added: “I want to thank Bob Doris for securing this debate, and the staff and volunteers at Highland Hospice for the terrific work they do every day.”

Kenny Steele, Chief Executive of Highland Hospice, said:

“I look forward to welcoming the Cabinet Secretary to Highland Hospice to discuss how we have been working, alongside partners, to shift palliative and end of life care from hospital to home.

“Since 2023, we have used charitable funding to pilot responsive home-based care for those at end of life, working alongside NHS Highland and our partners. This has allowed us to gather evidence showing that supporting people at home can improve the experience for patient and families while also reducing pressure on an already overstretched NHS.

“The challenge now is to build on what we have learned and make this model available to people across Highland.

“At present, the service is limited to Inverness, but with public investment we could extend this approach across the region, helping more people receive care in their preferred place while reducing avoidable hospital admissions and delayed discharges, at a lower cost than end-of-life care provided in hospital.”