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Dr Diane Laverty Macmillan Nurse Consultant Palliative & EoLC London Ambulance Service NHS Trust

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

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Dr Diane Laverty Macmillan Nurse Consultant Palliative & EoLC London Ambulance Service NHS Trust

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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

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

  4. Resuscitation decisions Decision Making Bereavement Paediatrics Advance care planning Reversible emergencies Symptom Control Communication National strategy Holistic care

  5. The EoLCChallenge 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? 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!

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