Hospitals in Romford and Ilford now have palliative end of life care specialists permanently based in their A&E departments.

A new scheme brought in by the NHS  trust running Queen’s and King George hospitals means staff can improve care for patients in their dying moments, while having “honest conversations” with them and their families.

It can mean helping someone wishing to die at home to leave hospital, while others have their last hours made more comfortable, via the use of a private room or a visit from a chaplain or priest, for example.

The hospitals’ trust has brought in paramedic specialist Josh Singleton, one of the few NHS workers in the country with combined skills in A&E and palliative end of life care.

“It’s important that staff are not scared to have conversations with patients and their loved ones about dying,” Josh explains. “It gives them a chance to make plans and say the things they need to.

“My mum was a palliative care nurse who died when I was 18 — but I didn’t get the chance to say goodbye.

“Sadly, many of the patients in our care are in the last days of life but we can give them the chance of a good ending.”

Having “open conversations about dying” Josh feels often takes away the fear of the unknown.

One woman patient had just hours left when Josh intervened, making sure she was able to spend precious time with her husband, while prayers were said by the hospital chaplain at their request.

“It’s not about where you die,” Josh said. “It’s who you die with. Most people would like to be surrounded by family in the last days and hours of life.”

Sharing expertise with A&E staff is part of the project, which the hospital trust says feeds back to GPs in the community.

Kathryn Clark, clinical nurse at King George Hospital’s A&E, said: “We see a lot of care home residents who don’t need to be in hospital but are brought in as there’s no advance care planning in place. We can feed things like that back to GPs.

“I’m often able to help patients spend as little time as possible in A&E and get back home where they are more comfortable.”

The presence of palliative specialists in A&E provides reassurance to medical staff as well, to stop unnecessary medical investigations.

“We are able to make a difference at the worst time,” Kathryn added. “Patients and their families are always grateful for our honesty.”

The  specialists also look after terminally ill patients when they first arrive in A&E, who need to be admitted, ensuring they are able to return home as soon as possible if they wish.