Paramedic palliative care team pilot is a game-changer, says GP

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A new ‘game-changing’ service in which specialist paramedics support people in their last days of life has been hailed by GPs.

The Welsh Ambulance Service Trust (WAST) appointed its first dedicated palliative care paramedics in October 2021

Specialist paramedics provide palliative care – which helps relieve the pain, symptoms and stress of people with a life-shortening illness – and also work alongside loved ones to support the care of their loved ones.

According to the Swansea Bay University Health Board (SBUHB), the four-person paramedic team trained at Morriston Hospital and now work alongside Swansea Bay’s specialist palliative care team, splitting their time between patients of the community and those of hospitals and hospices.

The pilot service which began in December is the first of its kind in the UK. Speaking on the health board’s website, Swansea GP Dr Chris Jones said the service was already making a real difference.

He said: “It’s a daunting field. Although we deal with such cases on a daily basis, sometimes it requires specialist intervention and liaison with a service that has more specialized knowledge and understanding.

“This is an area of ​​the utmost importance. This is a very critical time in the lives of people and their families. It is not something that can be delayed. These are situations that must be dealt with on the same day. The availability of palliative care paramedics has been a game changer. »

Steamed

Dr Jones said under the precedent someone from surgery or a palliative care nurse or doctor would visit the patient at home before making contact to work out a plan, but this could take time and delay the support.

Under the new initiative, the team can often respond the same day or even within the hour.

Dr Jones said: ‘I phone the advice line and speak to one of the palliative care clinicians. They provide guidance on what needs to be done on my side. If necessary, they will contact the paramedics who will come to the patient’s home.

“They liaise with observations and examination results, and with specialist advice if needed. We can arrange for prescriptions and medication charts to be provided to the family. It’s good for the patient and the family.

“Paramedics can provide that extra support for families. They link to the GPs and the consultant and act as the face of many services, rather than having a GP and a palliative care consultant and then possibly the GP again. They bring services together to support people.

Dr Jones said the service also enabled continuity of care, involving a GP, a palliative care consultant and a paramedic.

“Before, I might have been involved initially, but if I wasn’t available the next day another GP would pick it up. He streamlined the whole process, with obvious benefits for patients.

Flexible & responsive

The health board says having the paramedic team in addition to the pre-existing specialist nurse cover, which is available throughout the week, as well as the support of on-call specialist doctors makes the service more flexible and responsive. .

Another advantage comes from the fact that paramedics offer better availability at times when other services are more difficult to access, such as on weekends or in the evening, when very ill people and their families may have the Not needed anymore.

Swansea Bay palliative medicine consultant Dr Idris Baker, who helped train the specialist paramedics, said: ‘We are delighted to see how these paramedics are fitting into the team and grateful for the support from the ambulance trust as well as board of health to set them up and running.

“They add a string to our bow. We have contact with many people back home each year across Neath Port Talbot and Swansea. We can see many of them face to face, but we weren’t always able to do it as quickly as we wanted or needed.

“The responsiveness of paramedics and their skills in assessing patients and their situation are already so valuable in guiding how we support district nurses and general practitioners in their care. And they are so enthusiastic in how they go about it.

Ed O’Brian, Welsh Ambulance Service End-of-Life Care Manager, said: “We are delighted to hear that this joint initiative between WAST and Swansea Bay has been so well received, and that it not only benefits patients as well as other healthcare professionals.

“When we introduced this new role, it was the first of its kind, an untested concept. We are therefore constantly measuring and evaluating to ensure that it brings the maximum benefit.

“Receiving such positive feedback from Dr. Jones is really nice to read.”

WAST says it hopes to build on the success of the first role flown in Swansea Bay by extending the service to other parts of Wales.

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