Enhancing Palliative and End-of-Life Care: London Ambulance Service NHS Trust Strategies

London Ambulance Service NHS Trust implements strategies focusing on palliative and end-of-life care, including training ambulance clinicians, making resuscitation decisions, addressing challenges, coordinating care, and administering anticipatory medications. These initiatives aim to improve patient outcomes and reduce unnecessary hospital conveyances, ensuring holistic and patient-centered care.

• Palliative care
• End-of-life
• Ambulance service
• Patient-centered care
• Training

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Uploaded on Jul 31, 2024 | 0 Views

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1. LAS Strategy for Palliative & End of Life Care Dr Diane Laverty Macmillan Nurse Consultant Palliative & EoLC London Ambulance Service NHS Trust

2. What Do We Do? (1.4.17- 31.3.18) Almost 2 million calls to 999 Attended 1.1 million incidents PC coded calls 3111 31% average of PC calls conveyed to ED Average On Scene Time (min) Conveyed to ED Sector Name Total EOLC ED % 178 North Central Sector 509 74 34.97% 591 69 212 North East Sector 35.87% 921 77 248 North West Sector 26.93% 608 76 181 South East Sector 29.77% 486 71 138 South West Sector 28.40% London Ambulance Service NHS Trust

3. Ambulance Clinicians Training The 3 P s: Preserve life Promote recovery Prevent deterioration London Ambulance Service NHS Trust

4. Resuscitation decisions Decision Making Bereavement Paediatrics Advance care planning Reversible emergencies Symptom Control Communication National strategy Holistic care London Ambulance Service NHS Trust

5. The EoLC Challenge for LAS Non expert clinicians Time pressured situations No pre-existing knowledge of patient/family Limited documentation/information Variable OOH provision for specialist support London Ambulance Service NHS Trust

6. What information can help us look after your patients? How can we stop unnecessary conveyances to ED & keep patient at home if that is their wish? London Ambulance Service NHS Trust

7. Coordinate my Care (CMC) CMC plan, detailing: Personal & professional contact details PPC/PPD/DNACPR decisions Patient/family awareness Treatment escalation plans Symptom control hints & tips, including non pharmacological interventions London Ambulance Service NHS Trust

8. Anticipatory Medications Anticipatory medications when it is clear your patient is nearing end of life Paramedics CAN administer anticipatory medications Clear, unambiguous drug prescription / authorisation chart & stock balance chart London Ambulance Service NHS Trust

9. Advice, Collaboration & Support Creation of Appropriate Care Pathways (ACP s) Collaboration between hospices and LAS Identifying SPA / 24/7 advice & support service If you know/think you have one, please contact us! London Ambulance Service NHS Trust

10. What Can You Do? Can you be sure that your patients who are nearing EOL have a CMC care plan and anticipatory medications available? Do you have a system/process OOH for access to advice & support? Can we create an appropriate care pathway together? Would you be able to offer paramedic placement opportunities for shared learning ? London Ambulance Service NHS Trust

11. THANK YOU! London Ambulance Service NHS Trust