A Qualitative Exploration of Paramedics’ Views on the Development of Paramedic‐Delivered Services for Patients at the End of Life
Sinead Keeney, Felicity Hasson, Natasha Campling, Paul Slater, Sonja McIlfatrick, Julia WolfeBackground
Paramedics are increasingly involved in community end‐of‐life care, yet ambulance services often lack structures to support this expanding role.
Objective
To explore paramedic workforce perspectives on the development of paramedic‐delivered services for patients in their last year of life, in order to identify priorities for service development.
Methods
A qualitative descriptive analysis was undertaken using narrative free‐text responses from an online cross‐sectional survey of registered paramedics employed by the Northern Ireland Ambulance Service ( n = 137). Responses were analysed thematically, informed by Braun and Clarke’s (2006) framework, to identify system‐level priorities for service development.
Results
Three interconnected themes were identified: professional, organisational and system factors influencing delivery of end‐of‐life care. Paramedics highlighted the need for enhanced education and role clarity, specialist clinical support, improved interdisciplinary communication and stronger integration with palliative care pathways. Participants emphasised challenges related to out‐of‐hours support, access to anticipatory medications and availability of patient information, alongside the importance of public and family engagement in advance care planning.
Conclusion
Findings show that paramedics identify clear workforce, organisational and system enablers required to support community‐based end‐of‐life care. Addressing these priorities may facilitate more integrated, patient‐centred care and inform approaches intended to support care at home and avoid hospital conveyance where clinically appropriate. Workforce perspectives may provide evidence to inform ambulance service policy, workforce development and integrated palliative care planning.