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Ambulance services are a key player in end of life care team, NHS guide concludes

Ambulance services could support more people in achieving ‘a good death’ and reduce unnecessary or unwanted hospital admissions and treatment, according to a new guide published by the NHS.

'The route to success in end of life care - achieving quality in ambulance services' is the latest in a series of practical guides co-ordinated and published by the National End of Life Care Programme (NEoLCP). The guide, which has a case study using Warwick research, aims to improve care for people nearing the end of life in a variety of settings while making best use of available resources.

Ambulance clinicians are often the first or only health professionals present at a death or soon after a death. They can be called by panicked relatives or carers following a sudden deterioration or crisis. Frequently, however, they have no access to vital information such as the individual’s medical history or any results from advance care planning, such as advance decisions to refuse cardiopulmonary resuscitation.

Claire Henry, director of the NEoLCP and the joint national lead for the EoLC workstream of the Quality, Improvement, Productivity and Prevention (QIPP) challenge, emphasised the importance of other health and social care agencies working with their local ambulance services:

“For too long ambulance services have hidden their light under a bushel: after all, these are the people regularly faced with the reality of death and dying. Given the wide geographical scope of most ambulance services, they are ideally placed to draw commissioners and providers together to improve local end of life care and make best use of resources.

“Such relationships can ensure ambulance crews are provided with the information and support they need. They are also an opportunity for ambulance service leaders to draw on their crews’ experience to feed into the development of consistent policies and procedures around issues such as resuscitation. For too long, that insight has been under-utilised or ignored.”

Dr Dan Munday, Associate Clinical Professor in Palliative Medicine at Warwick Medical School, explained how Warwick's research had input into the new guidance:

"Our research explored the experiences, practices and training needs of ambulance crews relating to end of life care. This was used to inform an online education programme which was led by our partners at Coventry University.

"We were however aware that in an emergency situation it may be difficult for ambulance personnel to bring to mind knowledge they had gained through this education, so we have designed and tested a simple decision support tool to aid ambulance crews at the bedside. This has been well received and has been reported to help crews in making sound decisions or to given them confidence that the decision they had made was correct and appropriate."

Download the document from the NEoLCP website.

Further Information:
1) The National End of Life Care Programme supports the implementation of the Department of Health’s End of Life Care Strategy. For more information visit the programme’s website

For inormation about the input from Warwick Medical School or to speak to Dr Dan Munday, please contact Kate Cox, Communications Manager, Warwick Medical School on 02476 150483 or