Ambulance service is improving choice in end of life care

Categories: Care.

A dedicated ambulance service in Leeds is helping patients to die in their place of choice.

The Leeds Palliative Care Ambulance was set up in 2007 as part of the Marie Curie Delivering Choice Programme. Consultations with stakeholders had found that a lack of appropriate ambulance transport was a factor in preventing the fulfillment of patients’ wishes to choose where they where cared for at the end of life.

“The Palliative Care Ambulance service is quite unique to Leeds and benefits those patients with palliative care needs, their family/carers, healthcare professionals and healthcare providers” explains Ann-Marie Kelly, PTS Specialist Patient Engagement Officer at Yorkshire Ambulance Service.

The service is free of charge and available to people registered with a Leeds GP. Operating seven days a week, 365 days a year, it ensures appropriately trained ambulance personnel provide quality palliative care to patients while they travel.

It complements the existing patient transport service for palliative care patients, such as same-day discharges, admissions or transfers to the hospice, home, care home or community, and transfers patients quickly and safely to their preferred place of care.

It is also helping to reduce delays to the discharge of patients caused by restrictions to transport, and is aiding coordination between the hospital, hospice, care homes, community and ambulance services.

Currently the service faces a number of challenges, including time-consuming journeys with more patients travelling out of the area, and demand at peak times. “Due to the processes we work to (hospice admission times, DN initial assessments, care home deadlines for admission), organisations look at transferring patients at the same time in the day, and demand for the ambulance can then exceed capacity and patients have to be transferred to the Emergency Operations Centre” Ann-Marie says.

Other challenges are an increase in patients with more complex conditions and a greater level of need, and training issues, where there is a lack of knowledge or high turnaround of staff on the booking hub, resulting in mixed messages when booking.

However since the service began 12 years ago there has been improved city-wide collaboration between organisations – collaborative working with paediatrics has meant a transport service for ventilated children to hospices. Domiciliary support for transfers at home has been implemented – such as from upstairs to downstairs living, or installing a hospital bed – keeping patients at home in their preferred place of death.

The service is also helping to facilitate the patients’ end of life care wishes, by taking them to a significant event or outing, or taking a person home for the last time to sort out any personal affairs before transferring them to their chosen place of care.

“While improving service provision, it is expected that the number of people dying at home will increase” Ann-Marie says.

For more information visit Leeds Palliative Care Ambulance