The potential contribution of paramedics in primary and urgent care

Key findings:

Key findings of the review focused on the description of the paramedic clinical role in primary care and their work environment; the clinical activities paramedics undertake in primary care; patient satisfaction; and education and training for paramedics moving from the ambulance service into primary care.  One of the most interesting findings was that paramedics were able to apply their clinical skills, normally used to manage emergencies, in primary care.  Whilst this assisted in decreasing GP workload in some cases, in other cases patient consultation times were extended as paramedics needed supervision from GP's, and this served to actually increase GP workload.

Clinical work environment:

Paramedics were found to be working in:

• Home visiting services

• Minors units

      -  First aid units

      -  Minor injury units

      - Minors departments in hospitals

• Walk-in-centres

• General Practice;

• Out-of-hours services;

• A rotational role into any of the above settings, whilst retaining the ambulance service as the main employer.

Recommendations:

This review found no evidence of the optimal role of the paramedic in primary care, nor any standardisation of training programmes. This is likely related to the relative novelty of the role in primary care, inconsistencies in the application of the title, and the lack of correlation between title, role and education level, in contrast to that outlined by the College of Paramedics. The absence of a well defined role for paramedics may make the development of training programmes to prepare paramedics to work in these settings challenging. Clinical users, providers and policymakers should be mindful of these limitations. Research is needed into the best use of the paramedic resource in primary care to inform and develop the right training for the future.

What's next:

We continue to undertake further research to determine how, why and in what contexts paramedics are now working in primary care, and their contribution to the primary care workforce overall.

Further reading:

Extended project summary

BJGP publication: Contribution of paramedics in primary and urgent care: a systematic review 

Authors:

Georgette Eaton, Geoff Wong, Veronika Williams, Nia Roberts, Kamal R. Mahtani