What can paramedics do in primary care?
Paramedics in primary care can offer varied skills above and beyond a home visiting service, although some PCNs may choose to use paramedics as part of a home visiting service. Roles may include:
- Managing patients with acute presentations in a surgery clinic
- Home visiting
- Care homes
- Long term condition management and health promotion (with appropriate training)
Please also see the following video case studies which may support your PCN in deciding whether a paramedic is right for you.
Training and supervision
Pre-requisites– Under ARRs, paramedics within PCNs, need to have completed their two-year consolidation of learning’ period (ie newly qualified paramedic period) and have a further 3-years’ experience at AFC band 6 (or equivalent). It is expected that the paramedic will be working towards developing masters level (academic level 7) capability within 6 months of entering into primary care, and have completed the FCP roadmap by this stage (for details of the roadmap please see training below). A longer period of time can be agreed with the commissioner where appropriate for the PCN and paramedic. Where a paramedic is not working at academic level 7 capability (FCP level) the PCN must ensure they are working as part of a rotational mode, in which they have access to supervision and support.
Locally a rotational model is offered by SWAST. To express an interest in a rotational paramedic please get in touch with the training hub and we can provide further details of the additional cost and who to contact.
Training pathway– For those on a rotational model, with SWAST, training needs will need to be assessed separately within SWAST and the PCN. PCN training needs will need to be managed within PCN time, and likewise for SWAST training needs. For many paramedics on a rotational model, coming into primary care for the first time, a training needs analysis would be helpful. The following may provide a framework for paramedics to self-identify learning needs Paramedic Specialist in Primary and Urgent Care Core Capabilities Framework.pdf (hee.nhs.uk). A further guide for employers can be downloaded on the right hand side of this page. Further support will be provided from the regional Primary Care Academy as part of the rotational model.
For those directly employed by a PCN, and not on a rotational model, it is expected, that paramedics will complete the WT&E roadmap. There is an exception to the roadmap for experienced paramedics who were already working in Primary Care prior to 2021. The WT&E roadmaps provide a standardised educational pathway across multiple health professional groups, towards advanced practice for clinicians working in primary care. For a more detailed explanation of the first contact practitioner (FCP) and Advanced practitioner (AP) roles and training pathways please see the Advanced practice section (coming online soon). On the right hand side of this page is a link to download the roadmap for paramedics.
For those paramedics undertaking the roadmap they will need a roadmap supervisor. Roadmap supervisor courses (2 day training course available from WT&E) are available for:
- GP trainers (educational supervisors)- although ESs do not need the full 2 day course. GP trainers are automatically eligible to become roadmap supervisors. There is however an optional training webinar available for free from e-learning for health at Top up Training Video for GP Educational Supervisors – elearning for healthcare (e-lfh.org.uk).
- GPs (who are not educational supervisors/trainers)
- A clinician who has a post registration masters degree (pre-registration masters degrees DO NOT qualify)
- Are a full MACP member
- A FCP recognised by the WT&E centre
- An AP recognised by the WT&E centre
Over time it is hoped that much of the supervision needed on these roadmaps can be provided outside of GP roles. We will soon have the Primary Care Supervision fellows supporting the roadmap supervision work, and the training hub can connect the PCNs in with these fellows as appropriate.
For paramedics on a rotational model or not undertaking the roadmap supervision is still important to ensure patient safety and retention of skilled clinicians. Having a named clinical mentor is important, such as a lead GP or other suitably experienced clinician. In addition to a named clinical mentor/supervisor with regular contact time, having a identified day-to-day supervision is important.
E-portfolio for paramedics in primary care
The College of Paramedics conducted a review of available e-portfolios to support paramedics working in primary care to evidence their clinical capabilities. There is a collaboration with Fourteen Fish this being a familiar tool with GPs, and in addition to the FCP Roadmap capabilities being included, there is the platform to use as a community of practice within it. A anonymised organisational oversight to share data with WT&E in terms of where paramedics are working and if there are any specific areas where paramedics are finding challenges to completion.
The e-portfolio was design to encompass the roadmap, but it is also of use to paramedics employed both in/out of ARRS roles, and advanced paramedics to guide and collate evidence of their CPD.
For those new to primary care and on a rotational model with SWAST an induction program is being planned by the Primary Care Academy. Please contact the Gloucestershire Primary Care Training hub for further details as they are announced. The training will also be providing a more generic induction into primary care over the coming months.
We would encourage paramedics to form a peer support network within their own PCN where appropriate and numbers allow. If this is not available to you and you would like support to establish a peer support network please contact the training hub.
There is a link to download the job description on the right hand side of this page.
Paramedics under ARR’s – Expressions of Interest for SWAST Phase 3 recruitment
SWAST are seeking EOI’s for Phase 3 of their rotational Paramedic recruitment programme with EOI’s to be submitted by end January 2023.
If you are interested in recruiting a rotational Paramedic as part of SWAST’s Phase 3 recruitment, please can you action the following:
- To register interest in being part of SWAST’s Phase 3 recruitment, please complete the ‘Phase 3’ EOI form which can be obtained here and return to SWAST by no later than end January 2023. Please return all EOI forms to RotationalParamedics@swast.nhs.uk
Working with Workforce Transformation and Education NHSE&I have published the following guidance which describes the scope of practice of paramedics working in general practice and includes information on education/development needs, supervision requirements and the differences between enhanced, first contact and advanced levels of practice.
To access a SWAST rotational paramedic supervision guide please click here.