Dying Matters Awareness Week (6 to 12 May) focuses on ‘how we talk about dying matters’. This year’s national week comes as we’re a few months into a new project between our Palliative Care and A&E teams to improve care for palliative patients.

The A&Es at our hospitals now have a member of the Palliative Care team located there, able to identify patients nearing the end of their lives earlier and provide specialist care while having honest conversations with them and their families.

In some cases, it can mean helping a patient who wishes to die at home to return there, for others, it could be small changes to make their last hours in hospital more comfortable, such as a private room or visit from our Chaplaincy team.

As part of the project, we brought on board Josh Singleton, a palliative paramedic specialist, one of few NHS colleagues in the country with these combined skills.

He said: “My mum, who was a palliative care nurse, died when I was 18 and I didn’t get the chance to say goodbye. It’s really important clinicians are not scared to have conversations with patients and their loved ones about dying, as it gives them a chance to make plans and say the things they need to.

“Sadly, many of the patients in our care are in the last days of life and, if we do our job well, we can give them the chance of a good death. We have incredible ways of coping if we know what’s happening. Having open conversations about dying often takes away the fear of the unknown.”

Sharing expertise with their A&E colleagues is a big part of the project, as is feeding back to colleagues in the community.

Kathryn Clark, clinical nurse specialist in our Palliative Care team, who is mostly based in our A&E at King George Hospital, said: “We see a lot of care home residents who don’t need to be in hospital for treatment, however, they are brought in as no advance care planning has been put in place. We can feed things like that back to GPs.

“I’m often able to turn patients around quickly as well, so they spend as little time as possible in A&E and get back home where they are more comfortable. Our presence in A&E provides reassurance to colleagues as not everyone is a palliative care specialist, we can advise to stop unnecessary investigations. It’s lovely to be able to make a difference at the worst time, and patients and their families are always grateful for our honesty.”

As well as seeing patients when they first arrive in A&E, for those who do need to be admitted, the team continues to follow-up on them, ensuring they are able to return home as soon as possible.

In the first few months, 83 patients and their loved ones have benefitted. In one case, a patient had just hours left when Josh intervened, ensuring her and her husband were able to spend precious time together, with prayers from our Chaplaincy team at their request.

He added: “It’s not about where you die, it’s who you die with. Most people would like to be surrounded by family.

“It’s a real honour to do this job and be there for people in the last days and hours of life.”