Who would you trust to make the important decisions about your future if ill health meant you couldn’t do it for yourself? You’d probably want someone who knew you well enough to follow your wishes about how and where you’re cared for.

However, for hundreds of people in Glasgow each year, these decisions are being made on their behalf by someone who’s never even met them in their day to day lives, and has only seen them as a hospital patient. That’s because, if you lose capacity to make decisions for yourself through illness, decisions are made on your behalf by the health and social care team looking after you unless you have a Power of Attorney (PoA) in place.  

You might think it's something you don't need to trouble yourself with because you have a partner, parent, brother or sister or child who'll be there to do that for you, but that's not how it works by law. If you're incapacitated and don't have a PoA, you're in the hands of people who, while doing their best, can't possibly know what matters most to you.

Crucially, not having a PoA in place can lead to delays in being discharged from hospital when you are fit to leave, for hundreds of days for some people.  This is very distressing for patients and families, and also costly for our health and social care system, estimated to be around £250 million each year with 358,426 days spent in hospital by people whose discharge was delayed (up to end of March 2021).  Recent data shows that around 9% of adults in Scotland have registered a PoA since 2013.

So, what are we doing to address this?

When we identified the impact on delayed discharges in Glasgow back in 2013, we began a campaign to raise awareness about the benefits and the very real adverse impact of not having a PoA in place. The PoA campaign website was set up in 2013 as a one-stop source of information for the public and health professionals.

The success of the campaign led to it being taken up more widely, to Greater Glasgow and Clyde and Tayside in 2015, and then Scotland-wide in 2019, and we continue to support Health and Social Care Scotland’s PoA Day each September to raise awareness and increase uptake.

Overall, the most important thing we can all do is to start the conversation and get the message out there with our networks. Share the message with the people we care for and support, as well as with their families and carers. So, for example, it’s important that people who have a dementia diagnosis know how having a PoA in place can protect them in future.

We’re talking to the decision makers who can make the whole PoA process easier and more accessible for people, because we know from our research that there’s barriers that need to be removed such as cost, lack of clear information about the where to go to get a PoA and the complexity of navigating the whole system, as well as a reluctance to talk about something that’s naturally so ‘put offable’ on our to-do lists.

We’re looking to work with organisations such as the Office of the Public Guardian, the Scottish Government and Scottish Parliament, the Scottish Legal Aid Board and the Law Society of Scotland to see how we can take away barriers, make information clear and accessible and make the whole process of getting a PoA as straightforward and affordable as possible.  A recent mapping exercise of PoA registrations in Glasgow highlighted most people who don’t have a PoA in place live in our most economically disadvantaged areas, meaning there’s an issue of equality of access to wellbeing and independent living, given that people living in these communities are more likely to live with long term conditions from younger ages and more likely to need hospital treatment at an earlier stage in life.

In short, we’re talking with everyone who will listen with the aim of increasing the numbers of people who have a PoA in place.   

Get Involved and Spread the Word

Most of all, our workforce and our partners are our biggest assets in spreading the message, so we’re developing new information material to help you start the conversation with your networks, at work and even with your own family and friends.  

Ann Cummings, Service Manager at our Glasgow City Health and Social Care Partnership (HSCP), who chairs the National PoA Steering Group for Health and Social Care Scotland, is encouraging everyone to have the conversation about PoAs at work and at home: “It’s so important to have your PoA in place, no matter what age you are or what your family situation is. Please help us to spread the message. You can find videos, social media assets and information sheets at the PoA website, and please just let us know if there’s anything else that you’d find useful that isn’t there already. This year’s PoA Day takes place on 29 September, so look out for more information on that soon.”