Understanding the roles and work of paramedics in primary care: a national cross-sectional survey

Abstract

ObjectivesThis research aimed to fill a current knowledge gap, namely the current scope of clinical role of paramedics in primary care, in relation to specific constructs such a level of education and clinical experience.SettingThe survey was distributed to paramedics in primary care across the UK through the College of Paramedics.ParticipantsA total of 341 surveys were returned (male=215). 90% of responses were from paramedics in England, 1.7% from paramedics in Northern Ireland, 4.6% from paramedics in Scotland and 2.9% from paramedics in Wales. This represents approximately 33% of the primary care paramedic workforce in England and Wales. Estimates for percentages in Northern Ireland and Scotland are unavailable due to the lack of workforce datasets capturing paramedics in primary care.ResultsConsiderable variation was found in job titles, level of education and provision of clinical supervision of paramedics in primary care. Differing levels of practice were noted, despite guidance documents that attempt to standardise the role. Statistical analysis of quantitative data highlighted that relationships exist between paramedic clinical exposure in primary care, level of education, and ability of independently prescribe medicines and the extent to which clinical presentations are seen and examinations performed. However, free-text responses indicated that challenges in relation to access to further education and clinical supervision to support clinical development resulted in frustration for paramedics who work in this setting.ConclusionsAs well as offering an insight into the demographics of the primary care paramedic work force, there is indication of the clinical scope of role undertaken in this setting. Based on our findings, we recommend changes to education and support, governance and legislation to ensure paramedics employed in primary care can work to achieve the full extent of their professional capability.

GPs’ perspectives on diagnostic tests for children: a qualitative interview study

“…These do not account for all primary care healthcare personnel who request tests, including advanced nurse practitioners, specialist and practice nurses, pharmacists, and paramedics. 12 …”

Research agenda and priorities for Australian and New Zealand paramedicine: A Delphi consensus study

“…This result may be reflective of the rapidly evolving nature of Australian and New Zealand paramedicine, triggered initially by its inclusion as a registered health profession in the healthcare practitioner regulation schemes, and more recently the health system and workforce challenges in the post-COVID-19 pandemic era. The potential value and role of paramedics outside of jurisdictional ambulance services are increasingly recognised domestically and internationally, with prominent examples being paramedics in primary healthcare [38][39][40][41] and new jurisdictional service models such as community paramedicine. [42][43][44][45] There is clearly a strong appetite for greater examination of paramedics' role in the broader healthcare system, in or outside of jurisdictional ambulance service organisations, and the impact of these initiatives on systems and patients; 38 this specific item was prioritised first amongst all those on the agenda, and related items featured heavily amongst the top priorities.…”

Transition processes for newly qualified paramedics entering primary care: a critical discussion and theoretical perspective

“…The most recent survey of the paramedic workforce in primary care found that 7.6% ( n = 26) of responders had been a paramedic for less than 2 years prior to moving into their primary care role. 1 This figure suggests that a proportion of NQPs are seeking employment opportunities outside the traditional ambulance service employer, despite the assumption that paramedics working in primary care should possess a minimum of 3–5 years of experience. 2 Indeed, the number of paramedics employed in primary care has seen a remarkable uptick since 2016, 3 though this is not surprising given that paramedics have been specifically emphasised as a profession for recruitment into primary care.…”

“…It is this latter point that gives the profession its ‘USP’ to work in primary care, and recent work on this subject has indicated that it is the clinical experiences paramedics have in ambulance services that give them the clinical foundation to work in primary care settings. 1 , 6 However, questions arise about the opportunity cost to ambulance services of experienced paramedics transitioning to primary care, and the suitability of employing paramedics in primary care who have only recently obtained their registration.…”