SP-05 Death in ED – is this good care?

Introduction A death in the Emergency Department (ED) is often thought of as a failure of planning for an expected death – but that assumes people want to die elsewhere. Elsewhere is not always possible. Aims The spotlight session Aims to facilitate discussion about navigating this complexity whilst supporting patients, those who provide care and considering the intersectionality between palliative and emergency care. Methods Exploring existing evidence and lived experience of ED end of life care (EOLC). Results The Time to Care report noted that almost half of patients who died had visited the ED once or more in their last 3 months of life.1 A review reported that ED was often focused on living not dying,2 and there was no single model of EOLC in UK EDs. It recognised that it is a complex issue in a high-pressured environment, with lack of control.3 Furthermore a survey found ED staff were comfortable with breaking bad news, but less experienced staff were least confident. Staff reported that the infrastructure and clinical environment of ED was not conducive to provision of EOLC.4 There is also ongoing work describing the population who die in ED[5] and the variation in palliative care involvement.6 Marie Curie REACT (responsive emergency assessment and community team)7 reduced hospital use for patients in the last year of life, widened access to palliative care (from the most deprived areas), and received overwhelmingly positive feedback. Conclusion There is limited evidence about the people who die in ED and the best ways to provide excellent care to this population. Inclusion of the lived experience is vital for developing best practice. Impact There is a need for collaboration between clinicians in emergency medicine, palliative care and people with lived experience to better understand and improve the care of those who die in ED. References Johansson T, Pask S, Goodrich J, et al. (2024). Time to care: Findings from a nationally representative survey of experiences at the end of life in England and Wales. Research report. London (UK):Marie Curie Available at: https://www.mariecurie.org.uk/policy/better-end-life-report (Accessed: 22 October 2025) McCallum K, Jackson D, Walthall H , Aveyard H. (2018). Exploring the quality of the dying and death experience in the Emergency Department: An integrative literature review. Int J Nurs Stud 2018;85:106–117. McCallum K, Jackson D, Walthall H, Aveyard H (2025). Death and Dying in the Emergency Department: A New Model for End-of-Life Care. J Adv Nurs 2025;81:4000–4009 Foley J, Umana E, Saeed S, et al. Irish Trainee Emergency Research Network (ITERN) Collaborators (2025). Emergency clinician perceptions of end-of-life care in Irish emergency departments: a cross-sectional survey. Emerg Med J 2025;42(5):292–299. Edwards S, Ubayasiri N. (2025). End-of-life care in a major UK trauma centre. BMJ Supportive & Palliative Care. Published Online First: 03 March 2025. doi: 10.1136/spcare-2025-005421 Wilson S, Vince S, Jarman H, et al. (under review). Dying in the Emergency Department and the interface between emergency medicine and palliative care: a 12 month service evaluation from five acute hospitals. Submitted for publication 2025. NHS Confederation. (2025). Collaborating to provide care at home for terminally ill patients. Available at: https://www.nhsconfed.org/case-studies/collaborating-provide-care-home-terminally-ill-patients (Accessed: 22 October 2025)