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

Problem

Our recently published realist review (Eaton et al, 2021) highlights the complexity surrounding the introduction of paramedics into primary care roles. Our review of 205 documents published from 2004-2021 found that paramedic professional identity, interprofessional work and expectations of patients, General Practitioners, and paramedics themselves all required further understanding in order to determine the optimal employment of paramedics in this clinical setting. With a dearth of other research focussing on the paramedic role in primary care, we wished to address this gap by undertaking a cross-sectional survey of paramedics working in primary care across the United Kingdom to gain insight into their role, scope of practice and the contributions they believe they are making within this workforce.

Approach

The study consisted of a national cross-sectional online survey questionnaire addressed to paramedics working in primary care. The questioning focussed on gaining information relating to employment conditions, scope of practice, educational requirements and salary for paramedics working in primary care. A total of 341 surveys were returned.Data was analysed using descriptive statistics, chi-squared and kruskal-wallis tests, and a realist logic of analysis.

Findings

Considerable variation was found in role titles, scope of practice, and educational backgrounds of paramedics working in primary care. Relationships were found to exist between job title, prescribing status, education level and breadth of practice. In response to the free-text questioning, paramedics called for improvements in clinical supervision and continuing professional development (such as undertaking independent prescribing), alongside further support in navigating the transition into primary care.

Consequences

As paramedics’ transition into roles within primary care, their knowledge and skill set will undoubtedly change. In order to contribute to patients and the NHS primary care agenda, the current opportunities for paramedics' employment in primary care requires careful evaluation. This survey is the first to present empirical evidence of the current work undertaken by paramedics across the UK NHS, and offer insight into employment models, scope of practice, and relationships between job title, education level, prescribing status and scope of role.