Implementation of Paramedics in a GP setting at Haxby Group in Hull
As set out in the GP Forward View 1, the success of general practice will also rely on the expansion of the wider non-medical workforce. Similarly, the difficulties in GP recruitment are well publicised nationally2, with a similar trend being reflected in Hull. These drivers for change have led to expansion of the non-medical workforce in the form of three Paramedic practitioners, who are helping to aid the provision of urgent care in our four Hull-based sites, which are embracing new ways of working.
A project was undertaken to explore how Paramedics have been implemented within the workforce, including the exploration of competency-based triage system employed in order to select appropriate cases and level of GP supervision required, whilst exploring the extent that this can be modelled to enable implementation elsewhere.
The evaluation currently comprises quantitative and qualitative data, analysing training needs, capability in dealing with an array of presentations in Primary Care, respective workload, supervision arrangements and patient reported outcome measures. In order to gain qualitative data, semi-structured interviews with Paramedics and GPs were performed, whilst patients were asked to fill out a patient satisfaction survey. Quantitative data comprised of number of patients seen, array of conditions seen and the number of patients requiring GP follow-up.
The evaluation is showing both a demonstrable benefit of the expansion of wider non-medical workforce to include Paramedic Practitioners working in collaboration with GPs and is revolutionising structure structure of urgent care provision. We hope this will inform/enable implementation in other Primary Care settings.
Practice team roles involved
|Role||Involved in delivery||Impact upon role|
|GP||Required to oversee and supervise new paramedic practitioners
Involved in data collection
Evolved the way they manage urgent care patients
|More supervisory role
Evolved urgent care system
Ultimately will free time to focus on more complex clinical care
Potential to increase both number of routine appointments and length of consultations offered.
|Reception Staff||Need to be aware of the service and role of paramedics to both communicate to patients and to book appointments.
Provide feedback to evaluate service
|Need awareness of what is on offer for patients – book urgent care cases differently.|
|Office Function||Creation of appointment templates
Organising educational sessions
|Running different searches
Involved in feedback process as well as project design
|Practice Manager||Aware of project
Involved in design
Financial planning as business risk involved in changing delivery models
Involved in bid production for educational grants/bursaries for paramedics
|Involved in process and analysis of data/evaluation
Involved in strategic workforce planning in the future
|General Practice Nurse||Head of Nursing has become Head of Advanced Clinical Practice and is overseeing development of the practitioner group||Widening of the advanced clinical practice tier of clinical team
Broadening of Interprofessional learning activity within the practice
|Pharmacist||N/A||Involved in Interprofessional learning
Aware of role and able to communicate to patients
|Paramedic||Directly involved in clinical delivery
Involved in service design
Development of paramedic team
|Expansion of role
Clinical consulting & educational commitment
Involved in feedback, data collection and evaluation = service evolution
1 NHS England. Chapter Two: Workforce. General Practice Forward View. 2016 April.
2 Royal College of General Practitioners. New league table reveals GP shortages across England, as patients set to wait week or more to see family doctor on 67m occasions; 2015, February 8th [cited 2016, Jul 4, accessed online at www.rcgp.org.uk/news/2015/february/new-league-table-reveals-gp-shortages-across-england.aspx]