1. 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

2. Average On Scene Time (min)
What Do We Do? ( )
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%

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

4. 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.

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

6. 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?

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

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

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!

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 ?

11. THANK YOU!