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Delivering Community Emergency Medicine during the COVID-19 pandemic: the Physician Response Unit
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  • Published on: 30 April 2021
    Response to ‘Delivering Community Emergency Medicine during the COVID-19 pandemic: the Physician Response Unit’
    • Georgina Murphy-Jones, Macmillan Paramedic Lead London Ambulance Service NHS Trust
    • Other Contributors:
      • Diane Laverty, Macmillan Nurse Consultant: Palliative Care

    We read with interest your experience of creating care pathways for patients in the out-of-hospital setting during the Covid-19 pandemic, in particular for those with palliative care needs. The benefits of the Physician Response Unit (PRU) being tasked to end of life care related 999 calls, their enhanced level of assessment and management and the resulting reduction in inappropriate hospital admission is to be applauded. There is additionally a need to recognise the wider use of such care pathways, available pan London, that support palliative and end of life care (EoLC) patients accessing emergency care.

    In collaboration with hospice and palliative care teams the London Ambulance Service NHS Trust (LAS) has to date, created 19 EoLC appropriate care pathways. These offer our clinicians access to specialist advice, support with complex decision making and provide an alternative to Emergency Department (ED) conveyance. In the last 2.5 years we have undertaken an extensive programme to improve EoLC within the LAS; providing tailored education to augment our clinicians’ knowledge and confidence, creating guidance which includes medications and symptom management at the end of life and increasing clinician use of advance care plans. As a result we have seen a 15% increase in staff confidence and an 18% median reduction in ED conveyance for this patient group; most importantly more patients are being cared for in their place of choice and in line with their wishes....

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    Conflict of Interest:
    None declared.