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.