A scoping exercise to explore the current perceptions and attitudes of UK paramedics towards their role in the management of End of Life Care patients, in the pre-hospital setting

Background: Studies have highlighted that clinicians may not feel prepared to deal with end of life care patients as historically their training has been focussed on acute medical and trauma management. This has been shown to cause conflict with paramedic perceptions of their role. Although research exists that explores the attitudes and experiences of health and social care professionals who deal with palliative care patients on a routine basis, there is little evidence that explores the attitudes and perceptions of end of life care within the emergency pre-hospital setting. Aim of the study: To gain an understanding of UK paramedics perceptions and attitudes towards dealing with End of Life Care patients and carers/relatives. Methods: An online survey was distributed to all paramedics in the North West of England. The survey contained open and closed questions to enable collection of both qualitative and quantitative data to address the aims of the study. Demographic data including NHS band, personal experience and education & training was gathered in order to contextualise the data. Results: NHS band and educational background are the main influences on the participants views of End of Life provision provided by paramedics. Length of service as a paramedic and experience appear to be factors that affect confidence when dealing with these incidents in practice. The majority of participants rated that communication about End of Life Care between services is poor. Most participants would like EOL training to be mandatory and would prefer face to face training to self-directed learning packages. Conclusions: Communication between services is viewed as poor whilst staff backgrounds influences their views. Whilst the majority of paramedics feel that End of Life Care it is a key part of their role, there is a need for wider training to address differences in staff awareness, knowledge and confidence.