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Implementation of Paramedics in a GP setting at Haxby Group in Hull


Haxby and Wigginton Health Centre, 2 The Village, Wigginton, York, YO32 2LL01904 724600http://www.haxbygroup.co.uk/

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.

Aims

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.

Methods

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.

Results

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

Recruiting paramedics

Organising educational sessions

Data collection

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

 

References

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]

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