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Research project

Paramedicine delivered out-of-hours at end-of-life: a mixed methods evaluation of service provision

Lead researcher:
Research funder:
Marie Curie

Project overview

Paramedics are often important to patients in the last year of their life (end-of-life). We know that 999 calls are increasing for individuals and their families at end-of-life, which may be because services in the community are under pressure e.g. those provided by family doctors and community nurses. Little wide scale research has been carried out to understand the contribution played by paramedics in these situations and how this might be improved.

From practice it is known that paramedics attending patients at end-of-life face complex issues such as: not knowing the patient or their family, lack of availability of patient history, fear of doing wrong, issues with family conflict and
a lack of healthcare professionals to hand over to out-of-hours if the patient is to remain at home. These issues can mean people are admitted to hospital when circumstances mean they could be cared for at home.

The purpose of the study is to evaluate services and care provided by paramedics to people in the last year of life. We will survey paramedics throughout England to understand their professional practice and what
factors influence this, and conduct in-depth case studies (collecting information from patients, carers and healthcare professionals) to examine different ways of delivering services and how these shape paramedic decision-making and management of risk. It is important to evaluate service delivery and understand how the best service features can be incorporated into other services to improve the quality of care and support provided to patients and their families. This may prevent unnecessary hospital admissions at end-of-life, which often leads to people dying in hospital when most people state they would prefer to be cared for, and die, at home.


Lead researcher

Doctor Natasha Campling


Research interests

  • My research is focused on understanding experiences and processes at end-of-life, to improve support for patients and family caregivers during this time.  To do so my research has focused on the following areas, often co-producing and implementing interventions: 
  • Self-management at end-of-life

Connect with Natasha

Other researchers

Doctor Joanne Turnbull


Research interests

  • Urgent and emergency careHealth workforce and organisationPatient help-seeking and access to careTechnologies in healthcare deliveryEthnography, mixed methods and qualitative methods

Connect with Joanne

Professor Sue Latter

Professor of Health Services Research

Research interests

  • Medicines management
  • Prescribing

Connect with Sue

Professor Alison Richardson PhD, MSc, BN, PGDipEd, RN

Prof in Cancer Nursing/End of Life Care

Connect with Alison

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