Andy Brereton

Hospice Paramedic

Job Title: 
Specialist Practitioner in Palliative Care 
Place of Work: 
St Wilfrid’s Hospice, Chichester, West Sussex

What does your job include?
I work as a Specialist Practitioner within the Clinical Nurse Specialist Team and hold a caseload of around 40 patients at any one time, often visiting them at home.   My role focuses on  building relationships with patients, their families and carers,  from the moment of referral to our Hospice until after their death.   Constantly assessing their disease progression and its impact on every aspect of their lives, our approach prioritises acute symptom control, and we seek to work in partnership with both a patient’s consultant at hospital and their own GP.  We also explore wider issues including a patient’s psychosocial needs and support the wider family in often challenging situations, engaging with a diverse range of other agencies including Social Workers, Homeless Charities, Community Nursing Teams and faith groups of all disciplines.  We often lead very difficult and emotional conversations, helping everyone understand the dying process and, above all, strive to put as much in place to enable a “good death”.   


Photography by Matt Ryle.

How did you get into your role?
I have always had an interest in supporting people at the end of their lives and through bereavement, and was a clinical volunteer with the children’s bereavement charity Winston’s Wish.  After 11 years as an Ambulance Paramedic I wanted to find a role where I could spend more time with patients and their families.  After a personal contact introduced me to my local Hospice, St Wilfrid’s Hospice, I started to work with the Hospice at Home team as a Health Care Assistant on the bank.  This enabled me to understand the different approach to palliative care, without necessarily being in a lead role. After time I secured a part time contact within the same team as a band 6 practitioner.  The Hospice was creating a full time development role and I was one of three appointed to the Clinical Nurse Specialist Team as a Band 7 Advanced Practitioner, working through a structured two year competency based programme, and this was the first time St Wilfrid’s has ever appointed a paramedic. I now have the same permanent role as  Clinical Nurse Specialist and am working towards my Masters level Prescribing Course.  I’m delighted to say that St Wilfrid’s has just appointed their second paramedic to work on a similar competency based development programme.  

What do you think is the most important benefit of being a member of the College of Paramedics, and why?
I was keen to continue my membership of the College after I left the Ambulance Service as I wanted to keep connected to other paramedics, and to access the wide range of training and resources they have available.  The College information enabled the Hospice to consider and implement appropriate governance structures, having only ever employed nurses under the NMC.  It was vital to consider the College’s Career Framework and the Macmillan AHP Competency model when supporting the Hospice to create this new opportunity. I also feel reassured belonging to the wider community of Paramedics.