What is the perceived impact of paramedics working in primary care teams on the working practices of other professionals in primary care and the experiences of patients?

Problem

As paramedics’ transition into roles within primary care, their knowledge and skill set will undoubtedly change (National Institute for Health and Care Excellence, 2017a, 2017b; Primary Care Workforce Commission, 2015). In order to contribute to patients and the NHS primary care agenda, the current employment of paramedics in primary care requires careful evaluation.

Approach

Focussed observations were undertaken of paramedics working in primary care in 15 sites across England, Northern Ireland, Scotland, and Wales. 60 interviews were undertaken with paramedics (n=15), patients (or carers) who had received care from paramedics working in primary care (n=15), general practitioners who worked with paramedics (n=15), as well as other professionals employed in primary care, such as nurses and pharmacists, and administrative staff (n=15).

Findings

We found a lack of standardisation regarding the deployment of the paramedic role across the UK. Whilst paramedics we observed and interviewed were clear in their scope of role and contribution to the primary care team, General Practitioners generally reported a lack of knowledge regarding what the paramedic contributed to the practice team. All administrative staff interviews felt that the paramedic role was fundamental to freeing up time for GPs (versus any other health care professional), and other health care professionals felt paramedics were well integrated in the team, even if their role was not clear. Patients were positive in their encounters with paramedics, though they were not clear on why paramedics were seeing them instead of their usual GP.

Consequences

This research builds on previous work in this area, capturing the perspectives of the professionals who work with paramedics in primary care, patients they have seen, as well as of paramedics themselves. This research is the first to present empirical evidence of the perspective of the role of paramedics in primary care across the UK, and offers insights into factors relating to their deployment, employment, and how they fit in within the wider primary care team. On this basis, we have produced a series of practice implementation recommendations - as well as highlighted areas for further research in this area.