Article Text

Download PDFPDF
PP20  Paramedic identification and referral of patients in the last year of life: a stakeholder interview study
  1. Kim Kirby1,2,
  2. Sarah Black2,
  3. Laura Goodwin1,
  4. Lucy Pocock3,
  5. Alyesha Proctor1,
  6. Sally Richardson4,
  7. Joanne Stonehouse2,
  8. Hazel Taylor3,
  9. Sarah Voss1,
  10. Jonathan Benger1
  1. 1University of the West of England, UK
  2. 2South Western Ambulance Service NHS Foundation Trust, UK
  3. 3University of Bristol, UK
  4. 4Patient and Public Involvement, UK


Background Patients are approaching End of Life when they are likely to die within the next 12 months. Quality in End of Life Care is variable and identifying patients in the End of Life phase is challenging, particularly in those people with diagnoses other than cancer. Many patients accessing the ambulance service are in the last year of their lives and the role of ambulance services in recognising patients approaching the end of their lives is often overlooked. Patients who are End of Life should be offered advanced care planning.

Research Question What are stakeholders’ views on a paramedic screening and referral intervention aimed at improving care planning in patients in the last year of life?

Methods A qualitative study using semi-structured telephone interviews conducted with 17 stakeholders to investigate stakeholders’ views on:

  • the utility of a paramedic screening and referral tool

  • the likely impact of a paramedic screening and referral tool

Preliminary Results All staff groups:

  • Increasing advanced care planning would be advantageous for patients

  • Patients with non-malignant conditions are not readily recognised as End of Life.

  • Paramedics should use the Gold Standards Framework Proactive Identification Guidance to identify patients in the last year of life.

  • The proposed intervention has the potential to reduce unnecessary hospital admissions and unnecessary resuscitation.

Specific staff groups:

  • GPs: Concerns about additional workload.

  • GPs: The intervention is useful for patients who may ‘fall under the radar’.

  • GPs and ED doctors: Concerns about the need for paramedics to have sensitive communication skills.

  • Paramedics and GPs: A dedicated End of Life lead or team would be advantageous.

Conclusions The introduction of an end of life screening and referral tool into paramedic practice is a welcome intervention and will have a positive impact on patients at the end of life. GPs expressed concern about capacity to manage referrals.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.