Pioneering end-of-life care at London Ambulance Service

A. Last year, London Ambulance Service brought in three new Macmillan Cancer Support-funded posts, aimed at helping to educate ambulance service staff in end-of-life care. Macmillan has invested £467 400 in funding over a 2-year period, to enable the ambulance service to recruit three new roles, including a Macmillan Paramedic Programme Lead, which will support ambulance teams working with terminally ill patients, ensuring their wishes are respected, and unnecessary and distressing admissions to emergency departments are avoided.

A. Palliative and end-of-life care has traditionally not been part of the role of paramedics and other ambulance clinicians. As an emergency service, our traditional training has focused upon immediate medical interventions and the preservation of life. Considering those patients who may be more appropriate for palliative treatment is a shift in both our education and culture. Our programme aims to improve the decision-making skills and confidence of clinicians in ambulances and in our control room in end-of-life care.