Marie Curie in Scotland

The Marie Curie Nursing Service(1) (MCNS) is the main provider of nursing care to palliative patients in the Scottish area of Lothian(2). A service level agreement is negotiated with the NHS. The funding is approximately 50-50, with no direct cost to patients or family caregivers.

MCNS employs registered nurses and skilled healthcare assistants (HCAs)(3). Historically, they provide mainly night cover, from 10 p.m. to 7 a.m.

MCNS is now seeking to provide more flexible forms of care. These include rapid response nursing, where a nurse may visit several patients at short notice during a single shift, and fast track services, helping a patient to be discharged quickly in order to die at home.

MC staff provide one-on-one nursing care and support the patient’s family and carers, enabling them to rest or sleep. On occasions, they provide respite care. The district nurse(3), who is the case holder, provides the patient’s care plan. It includes practical details on risk assessment (for the caregiver and the patient) ; instructions on transferral ; decisions of advance planning such as DNACPR(4).

MCNS promotes the renowned Liverpool Care Pathway(5) as the best practice evidence-based framework for delivering quality final hours-and-days care to PC patients.

Professional development may include training colleagues, for example in the use of syringe drivers and pumps, which make easier subcutaneous drug delivery and are widely used in PC treatment.

With thanks to Fiona Colvile, Nursing Services Manager, MCNS, Lothian, Scotland.