The Last Year of Life. Palliative and End of Life Care: Episode 2

In our previous episode, we explored the meaning and importance
of end-of-life care, particularly during the final 12 months of
life. We discovered how difficult it is to predict this timeline,
especially for ambulance clinicians who often see patients at
critical points without a full picture of their medical history.


In this episode, we take a closer look at what that final year
can involve, focusing on the pre-hospital setting. We’ll explore
the unique challenges ambulance clinicians face in making rapid,
high-stakes decisions, and how existing documentation—such as
care plans or advance directives—can provide valuable guidance in
those moments.


We'll also discuss the role of shared decision-making and how
ambulance services can help balance specialist and generalist
palliative care needs. Alongside this, we’ll highlight how the
NHS Long Term Plan and other key initiatives aim to improve care
coordination and ensure more consistent, compassionate care.


Lastly, we’ll examine the barriers to effective advance care
planning. These range from cultural sensitivities to systemic and
logistical obstacles. Throughout, we’ll consider how we can
better support ambulance clinicians to deliver thoughtful,
person-centred care during some of life’s most vulnerable and
uncertain moments. Please find links to the SPICT Tool that is
mentioned in the episode:


https://www.spict.org.uk/#:~:text=Supportive%20%26%20Palliative%20Care%20Indicators%20Tool,is%20a%20plain%20language%20version.