Paramedics’ Perceptions and Experiences Providing End-of-Life Care: A Cross-Sectional Survey

Background: Many people spend their last year of life at home, with most wishing to die there. Evidence suggests paramedics facilitate over half of emergency department visits for palliative care patients, many of which are avoidable. Objective: To explore the perceptions and experiences of providing end-of-life care amongst paramedics in one region of the United Kingdom. Design: Online descriptive cross-sectional survey design using the ParAid Questionnaire. Quantitative data analysed using descriptive statistics. Setting and Participants: 182 paramedic respondents completed the questionnaire online (34% response rate). Results: Respondents reported numerous barriers to delivering end-of-life care. Access to medicines was problematic, with 54% reporting that they ‘always’ or ‘often’ had no access to specific medicines needed for symptom control. Education gaps were also evident: 67% reported that lack of pre-registration end-of-life care education and 71% that lack of post-registration education ‘always’ or ‘often’ influenced their ability to meet patients’ needs. Only 28% felt ‘very’ or ‘extremely’ competent in supporting patients and families in the last year of life, while 47% reported experiencing a ‘fear of doing the wrong thing’ ‘always’ or ‘often’. Access to information and referral pathways also presented challenges: 88% reported that they ‘always’ or ‘often’ lacked access to existing Advance Care Planning documentation, while 62% reported that they ‘rarely’ or ‘never’ had access to a specialist palliative care team out-of-hours. Conclusions: Findings emphasise the need for improved palliative care education, support structures, and improved access to information and medicines for paramedics. Findings identify potential areas for service development, including training, communication, and referral pathways, which may better support paramedics in providing end-of-life care.