Marie Curie strongly urges the Committee to consider access and delivery of palliative and end of life care in rural and remote areas. Key challenges Challenges in palliative care access and delivery can be evidenced through four ‘As’ : 1. Availability; of resources for palliative and end of life care providers, including specialist palliative care teams, social care workforce and carers, to meet the needs of terminally ill people. Challenges with resources include workforce recruitment and retention, equipment and technology in care homes, hospices, hospitals and at home 2. Accessibility; challenges terminally ill people, their families and carers face accessing palliative and end of life care, including access to medicines pharmacy support. Intersectional transport issues are at the heart of this. 3. Accommodation; how palliative care providers meet terminally ill people’s preferences and needs; of greatest concern are 1) existing out of hours of operations in rural and remote areas, e.g. how phone calls are handled, by whom and how they are actioned, and 2) a patient’s ability to receive palliative care without prior appointments (including emergency admissions) Accommodation also relates to the condition of terminally ill people’s own homes, and challenges with ensuring homes are fit for purpose to receive palliative and end of life care, and to die there, if that is their wish. 4. Affordability; of living in rural and remote areas. The “rural premium” means those living in rural and remote areas face significantly higher costs in housing, energy and food among others. This is before additional costs associated with terminal illness, including energy, housing, transport, which Marie Curie projects costs an individual between £12-16,000 per year. Affordability also centres around sustainability of palliative care funding in rural and remote areas. Urban centric models are usually transferred, ineffectively, to rural and remote areas because they do not reflect rural and remote challenges as above. These unique challenges highlight palliative and end of life care access and delivery in remote and rural areas as an inequity worthy of exploration by the Committee.
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