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Hospice advice and rapid response service for ambulance clinicians
  1. Tom Dent1,
  2. Inderia Tipping1,
  3. Racquel Anderson1 and
  4. Charles Daniels1,2
  1. 1 St Luke's Hospice, Harrow, UK
  2. 2 Palliative Medicine, Northwick Park Hospital, Harrow, UK
  1. Correspondence to Dr Charles Daniels, St Luke's Hospice, Harrow HA3 0YG, UK; cdaniels{at}


Objective Patients in the last year of life experience medical emergencies which may lead to an emergency attendance by ambulance clinicians and some patients having a transfer to hospital even when this is unwanted by patients, carers or professionals. Here we report the patient characteristics and outcomes of a 24-hour hospice nursing telephone advice service to support an ambulance service.

Method An evaluation of the outcomes of ambulance calls to a nursing telephone advice service for people living in northwest London, UK, attended at home during a 6-month period by the London Ambulance Service, whose clinicians then sought advice from the hospice’s 24 hours’ telephone line.

Results Forty-five attendances of 44 acutely ill people with palliative care needs resulted in a telephone call. Thirteen patients (30%) were male and the median age was over 80 years. Thirty-two attendances (71%) were managed without a transfer to hospital, with telephone advice from the hospice and in some cases arrangements for another clinician to visit. Seven attendances (16%) resulted in a transfer to hospital, of which at least five led to an admission. Six attendances (13%) resulted in a notification of the patient’s death.

Conclusions This preliminary study shows the feasibility, outcomes and acceptability of telephone advice to support ambulance clinicians attending patients with palliative care needs. The service was associated with low rates of subsequent transfer to hospital. Further controlled research is needed to assess the clinical and cost-effectiveness of the service.

  • home care
  • terminal care
  • service evaluation

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  • Contributors CD and TD conceived the study. IT and RA collected and analysed the data. TD wrote the first draft and all the authors contributed to subsequent drafts and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The London North West University Healthcare NHS Trust Health Service Research manager confirmed that this was a service evaluation and did not require research ethics committee approval.

  • Provenance and peer review Not commissioned; externally peer reviewed.