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Sharing information aims to reduce anxiety for patients with terminal illness

Cwm Taf University Health Board is the only health board in Wales to share end of life patient advance care plans (ACP) with Welsh Ambulance Service Trust (WAST) control room staff.

An advance care plan is a document completed by palliative care (end of life care) patients detailing their preferred place of death and preferences for care at the end of their life, including treatments and interventions they would or would not wish to have.

Andrew Morris, Macmillan Advance Care Practitioner at Cwm Taf said: “By providing these documents to WAST, their control room staff can advise the ambulance crew en route to the patient about the contents of the advance care plan.

“The feedback received from patients and their carers has demonstrated a real sense of relief and reassurance at being able to express and understand individuals’ preferences for their end of life care, and can help relieve carers of the burden of difficult decision making.

“We will continue to promote and develop advance care planning in care homes and community hospital settings, and to engage more GPs in undertaking and recording advance care planning.”

Paramedics responding to end of life care patients often do so without prior knowledge of the patient’s palliative condition.

The details ambulance control receives will frequently only be part of the presenting problem, for example a 999 call may be received for difficulty in breathing.

On arrival the crew have no background knowledge or access to current or past medical history. Having no background information will inevitably result in questioning from the ambulance crew in order for them to try and establish a cause for the patient being unwell.

For end of life care patients and their families this would likely result in the need for them to have that same distressing conversation they need to have every time a new health care professional becomes involved.

The place of death can be a critical contributor to the quality of a person’s last days of life, and for their family and friends.

It affects their physical, mental, social and spiritual comfort and may provide the opportunity for family and friends to be present during the final hours of a person’s life.

Edward O’Brian, End of Life Care Lead for WAST said: “This project has allowed WAST to have electronic access to advance care plans (ACP) in Cwm Taf for end of life care patients.

“The address is flagged in order to make our control room based clinicians aware of a 999 call to an End of Life care patient with an advance care plan.

“Valuable information and patient wishes can then be shared with the crew whilst on route to the patient.

“This now means ambulance crews in Cwm Taf arrive knowing the patient’s background medical history and also being aware of any preferences the patient has recorded regarding their future care.”