University of Southampton Study Reveals Challenges Faced by Paramedics in Providing End-of-Life Care in England

University of Southampton Study Reveals Challenges Faced by Paramedics in Providing End-of-Life Care in England

(IN BRIEF) A study conducted by the University of Southampton reveals significant challenges faced by paramedics in responding to end-of-life patients in England. Key issues identified include a lack of patient information, barriers to medication administration, and insufficient training, which impact paramedics’ ability to provide effective care. The research, funded by Marie Curie and supported by the NIHR, highlights the increasing reliance on paramedics due to a growing aging population and shortfalls in community healthcare services. Recommendations from the study focus on improving end-of-life care training, better access to patient records, and ensuring paramedics can administer necessary medications without delay.

(PRESS RELEASE) SOUTHAMPTON, 13-Feb-2025 — /EuropaWire/ — A study from the University of Southampton has revealed significant challenges faced by paramedics in England as they respond to an increasing number of end-of-life patients. Published in BMC Palliative Care, the research highlights issues such as a lack of patient information, barriers to administering medication, and inadequate training, all of which hinder paramedics’ ability to provide optimal care to those at the end of life.

Funded by Marie Curie and supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Wessex, the study points to the growing reliance on paramedics as community healthcare services face shortages, and an aging population requires more attention during the last stages of life.

Dr. Natasha Campling, Associate Professor at the University of Southampton and the lead author, explains that paramedics are often expected to handle complex decisions when responding to end-of-life cases. “Unlike typical emergency situations where the primary goal is to stabilize patients for hospital transfer, paramedics at end of life need to distinguish between conditions requiring medical treatment and those that can be addressed with palliative care and symptom management. Our research reveals that paramedics are making these tough decisions without the necessary support, information, and training.”

To understand the challenges better, the research team surveyed over 900 paramedics from all 11 NHS trusts in England. The findings show that paramedics frequently attend to patients in their last year of life, with 57% estimating such calls happen at least every seven shifts. Despite this, nearly half of paramedics (45%) reported never or rarely knowing a patient’s end-of-life status before arrival.

The study also found that paramedics often lack access to critical information, such as the patient’s medical history and advance care plans, which outline care preferences. As a result, paramedics frequently encounter disagreements over how to care for the patient, particularly when family members or healthcare providers differ on the best course of action. In many cases, paramedics face difficulties in challenging recommendations from other healthcare professionals, particularly when those recommendations involve hospital transfer, which they may not agree with.

Additionally, paramedics reported problems obtaining necessary medications, such as anticipatory drugs, and faced challenges in accessing the appropriate authorization to administer these medications.

Dr. Sarah Holmes, Chief Medical Officer at Marie Curie, emphasized the need to equip paramedics with the tools and training necessary to handle end-of-life situations. “While life preservation remains their primary focus, this study highlights the increasing number of palliative care scenarios paramedics face, making it crucial to ensure they have the proper resources and training to support the wishes of end-of-life patients.”

Professor Sue Latter, co-author of the study, further noted that the challenges have left many paramedics uncertain and anxious about making the right decisions in such sensitive situations. The research makes several recommendations, including enhanced end-of-life care training, improved access to patient records, better referral pathways, and ensuring paramedics have the authority to administer necessary medications.

Professor Latter added, “As paramedics are likely to continue playing an important role in end-of-life care, addressing these challenges to ensure they can access and administer critical medicines is essential to reducing unnecessary hospital transfers.”

The full findings of the study, Paramedics providing end-of-life care: an online survey of practice and experiences, are available in BMC Palliative Care.

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SOURCE: University of Southampton