Paramedics and hospice join forces to share end of life care knowledge

East of England Ambulance Service NHS Trust (EEAST) is leading the way in joining up the skills of emergency and end of life care professionals in the community by embedding its paramedics in St Helena Hospice, in a scheme that is thought to be one of the first of its kind in England.

Three paramedics are working in rotation between the ambulance service and St Helena Hospice’s SinglePoint – a 24/7 helpline and rapid response service for people receiving end of life care and support at home across north-east Essex.

The split role offers a unique opportunity for collaborative working, while sharing skills and knowledge between the organisations, and focuses on helping end of life patients get the help they need, while respecting their wishes to be cared for at home.

“For our patients, it’s about keeping them in the place where they want to be cared for and giving them support so they can remain at home and are less likely to be conveyed to hospital. Having the paramedics on the team has added value to our SinglePoint service. Their skill sets are different so they can go out and do their assessment and diagnostics, and if a patient has fallen, they can often do wound care there and then.

“We’re now getting more calls from paramedics out on the road generally because the paramedics working with us are telling their colleagues about what we can do at St Helena, whereas their first thought previously would have been to take the patient directly to hospital. The paramedics feel more comfortable having conversations about advance care planning and recognising what’s needed for patients in the dying process.”

Nicky Coombes, Hospice in the Home Matron at St Helena.

For the ambulance clinicians, dealing with end of life patients and supporting their families are another set of skills they can use to develop professionally. 

They can also take a further training module in end of life care that EEAST has developed with the University of East Anglia. 

“Having our clinicians embedded within St Helena Hospice’s SinglePoint system means the nursing team can benefit from our staff’s training in making swift assessment. This allows them to assess and deal with many patient’s non-urgent issues – often without the need to call an ambulance or transport them to hospital.

“This ensures people can get the care they need, while staying in their own home for as long as possible.”

Rachel Hunt, End of Life Care lead for EEAST.

In the collaborative effort between the East of England Ambulance Service (EEAST) and St Helena Hospice, Scott O’Rourke, an EEAST paramedic in rotation with the hospice, sheds light on the practical aspects of their partnership. During his day shifts at St Helena Hospice, he operates from SinglePoint, conducting patient assessments and providing assistance to enable individuals to stay at home.

On night shifts, he transitions to the ambulance service, serving as a paramedic on rapid response cars or emergency ambulances, responding to a diverse array of calls. This unique arrangement allows him to continually hone his skills in chronic and acute assessment and treatment.

The symbiosis of roles ensures an integration of knowledge, with the ability to incorporate the latest treatments and medications into hospice care. Conversely, experiences gained as a paramedic responding to community calls inform his approach when patients are rapidly deteriorating or approaching the end of life.

Scott highlights the invaluable communication skills acquired at St Helena Hospice, particularly in addressing advance care planning with patients and their families. Moreover, he emphasises the significant contribution of acute assessment skills, acquired as a paramedic, in identifying treatable conditions for patients receiving hospice care at home.

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