Barriers to paramedics using alternative pathways for patients near the end of life

Background: Demand is growing for community end-of-life care. With the unsustainable pressure on UK urgent care provision, it is increasingly falling to paramedics to initiate and provide this. This study aims to explore the opinions and experiences of UK paramedics managing patients at the end of life and perceived barriers to the use of alternative pathways to acute and unscheduled admission. Methods: An anonymous online questionnaire was circulated via a variety of paramedic-focused social media groups. Findings: A data set of 161 UK paramedics was obtained. Six themes were identified and explored: recognition of the end of life; difficult conversations; perception of the paramedic role; employer/guideline support; pathway availability; and training. Conclusion: Training is needed to improve paramedics’ understanding of the end-of-life process and improve confidence when initiating difficult conversations. It is imperative that other healthcare professionals recognise the unique position of paramedics within community health services and their evolving role in implementing effective, sustainable and patient-centred end-of-life care.