GP praises palliative paramedic team

A service which sees specialist paramedics supporting people in their last days of life has been hailed as game-changing by a Swansea GP.

Dr Chris Jones, of Llansamlet Surgery, said the new service streamlined the process with obvious benefits for patients and families.

Last October, the Welsh Ambulance Service Trust (WAST) appointed its first dedicated palliative care paramedics.

Palliative care expertise

Following training at Morriston Hospital, the four-strong team now works with Swansea Bay's specialist palliative care team, dividing their time between patients in the community and those in hospitals and hospices.

The pilot service, the first of its kind in the UK, commenced in December and, said Dr Jones, was already making a real difference.

"It's a daunting area. Even though we deal with such cases on a daily basis, it sometimes needs specialist input and liaison with a service that has more specialised knowledge and understanding.

"It is an area of the utmost importance. It is a very critical time in people's lives, and their families," he said.
"It's not something that can be delayed. These are situations that have to be dealt with on the same day. Having the palliative care paramedics available has been game-changing."

Bringing services together
Dr Jones said that, previously, someone from the surgery or one of the palliative care nurses or doctors would have gone out to the patient's home and liaised to make a plan, but that would often take time.

Now, he said, it was all done on the same day, sometimes within the hour. "I phone the advice line and speak to one of the palliative care clinicians," said Dr Jones.
"They provide advice about what needs to be done at my end. If appropriate they will contact the paramedics who will go out to the patient's home.

"They liaise back with the observations and examination findings, and with specialist advice if it's needed.

"We can arrange for any prescriptions and drugs charts to be provided to the family. It's good for the patient, and the family.

Family support

"The paramedics can provide that extra support to the families. They link with the GPs and the consultant and act as the face of many services, rather than have a GP and a palliative care consultant, then possibly the GP again.

"They are bringing services together to support people."

Dr Jones said the service also allowed continuity of care, by involving one GP, one palliative care consultant, and one paramedic.

"Previously I may have been involved to begin with but if I was not available the following day, another GP would pick it up.

"It has streamlined the whole process, with obvious benefits for patients."
Another benefit is that the paramedics can help make the team available more often when very ill people and their families may have the greatest need, including weekends when other services may be harder to access.

For some years there has been a specialist nurse available seven days a week and support from on call specialist doctors.

But the paramedics add a new strand to what's provided and makes it easier to respond more quickly each day.

Swansea Bay Palliative Medicine Consultant, Dr Idris Baker, helped trained the specialist paramedics.

He said: "We're so pleased to see how these paramedics are fitting into the team and grateful for support from the ambulance trust as well as the health board to get them up and running.

"They add a string to our bow. We have contact with lots of people at home every year across Neath Port Talbot and Swansea.

"Many of them we can see face-to-face, but we haven't always been able to do that as quickly as we wanted or as they needed.

"The paramedics' responsiveness and their skills in assessing patients and their situations are already so helpful in guiding how we support district nurses and GPs in their care.

"And they are so enthusiastic in how they go about it."

Ed O'Brian, the Welsh Ambulance Service's End of Life Care Lead, said: "We're so pleased to hear that this joint initiative between WAST and Swansea Bay has been so well received, and that's it's benefiting not only patients but also other health care professionals.

"When we introduced this new role, it was the first of its kind, an unproven concept, so we're constantly measuring and evaluating to ensure it is bringing maximum benefit.

"Receiving this positive feedback from Dr Jones is really pleasing to read."
WAST says it hopes to build on the success of the role first piloted in Swansea Bay by expanding the service to other areas of Wales.