One in three people in Scotland die with unmet palliative care needs, alarming new figures reveal — with rural communities facing some of the starkest challenges.
New findings published by Marie Curie Scotland show that around 18,500 people across the country are struggling to access the palliative and end‑of‑life care they require. This figure is expected to rise by 14 per cent by 2050 unless significant action is taken.
The statistics calculated using a methodology developed through the DUECare Project by researchers at King’s College London, Hull York Medical School and the University of Edinburgh, provide the most accurate picture to date of unmet palliative care needs in Scotland. The updated approach identifies unmet need where people experience both substantial unaddressed symptoms and insufficient access to GP‑led care.
Local constituency MSP Finlay Carson said the findings highlight longstanding concerns about the availability of palliative and end‑of‑life services, particularly in rural areas.
He said: “It is clear that greater resources are needed to ensure that patients get and receive the palliative care that they are due. It is tragic to think that people are dying without being afforded care that could make their final days or months more comfortable.”
Mr Carson said the figures underline wider concerns about the lack of dedicated end‑of‑life provision across rural regions — including areas with no hospice facilities at all.
"In many rural communities, there is a worrying lack of understanding about the scale of unmet end‑of‑life need. Unlike urban centres, vast areas of the south‑west have no hospice whatsoever. Families often rely on small community organisations, district nurses, or overstretched GP practices to fill the gaps.”
He said that while several voluntary and community groups were doing “extraordinary work” to support patients, they could not be expected to shoulder responsibilities that require consistent, properly funded services.
“These organisations are doing fantastic work, often going far beyond what should reasonably be expected of them. But a civilised society must ensure dignity, comfort and proper support at the end of life — no matter where someone happens to live. Rurality should not mean reduced access to compassion or care.”
Mr Carson said the health board and government must work together to address the imbalance in service provision.
“We urgently need a strategic approach that recognises the unique needs of rural areas — from the absence of hospice beds to limited 24/7 nursing cover. These challenges have been known for years, yet many communities are still without the specialist support they need at the most vulnerable time in their lives.”
He added:
“As the population ages and the number of people dying with unmet palliative needs continues to rise, it is essential that end‑of‑life care becomes a genuine priority. Everyone deserves dignity and proper care at the end of their life — and we must act now to make that a reality.”