Palliative & End of Life Care

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Presentation transcript:

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

Average On Scene Time (min) 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 Sector Name Total EOLC Average On Scene Time (min) Conveyed to ED ED % North Central Sector 509 74 178 34.97% North East Sector 591 69 212 35.87% North West Sector 921 77 248 26.93% South East Sector 608 76 181 29.77% South West Sector 486 71 138 28.40%

Ambulance Clinicians Training The 3 P’s: Preserve life Promote recovery Prevent deterioration

Reversible emergencies Resuscitation decisions Decision Making Bereavement Paediatrics Advance care planning Symptom Control Reversible emergencies Communication National strategy Holistic care Part 1– introduction, patient assessment and considering psycho/social/emotional care. Part 2 – focus on patient management and practical aspects of care.

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

What information can help us look after your patients 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?

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

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

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!

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 ?

THANK YOU!