How many end-of-life care patients access unscheduled care via 999?

Background: In Wales, the number of patients who are in their last year of life who access unscheduled care via emergency ambulance services is undocumented. Aims: This study aimed to identify and analyse the number of adult end-of-life care patients in Wales accessing unscheduled care via ambulance services and subsequently transferred to hospital. Method: Secure Anonymised Information Linkage (SAIL) datasets were cross-matched to a subset of Office for National Statistics' Annual District Deaths Extract, where people had been assessed as ‘likely having a palliative condition pre death’ by two independent palliative medicine doctors. Findings: On average, 89% of patients in Wales likely to have a palliative condition accessed unscheduled care via the ambulance service in their last year of life, most likely in the their final 7 days. Conclusion: Ambulance services play a crucial role in supporting community end-of-life care.