Despite the profession being around for some 50 years, many people are still unsure of what a Paramedic actually does. As a consequence I thought I’d give you a quick potted history; but before I get into it here’s a spoiler alert…….it’s more than just driving fast!
The profession was born of the ambulance service in 1971, the brainchild of a cardiologist Dr Douglas Chamberlain. He realized that improving immediate medical care was essential to saving life and improving outcomes for patients. On the strength of this realization he decided it was essential to improve the training of ambulance crews. It all started with an 8 week “extended care” course in coronary care and airway management and has kept on growing since.
Paramedics now complete a three-year degree program and are expected to manage almost every aspect of health from delivering a baby to caring for people at the end of their life with pretty much everything else in between.
Like other health care professional such as physios and radiographers they are registered with and accountable to, the Health and Care Professions Council (HCPC). As a consequence it’s actually illegal to refer to yourself as a Paramedic without being registered.
Most Paramedics still work for the ambulance service but in recent years the NHS has increasingly realized that here is a group of highly skilled clinicians who are trained in examination and diagnosis and accustomed to independently identifying and treating a wide range of conditions. In fact, a very similar role to that of a Doctor. That led to the thought that we could add value in a much wider range of settings. As a consequence of this, Paramedics are now working in hospitals, urgent care centres and GP surgeries as well as the ambulance service.
The development pathways have also grown with the profession and we now have Paramedic Practitioners, with a range of additional urgent care skills and in some cases the ability to prescribe medication in their own right.
The simple truth is that common things happen commonly and the vast majority of health complaints can be dealt with by specialist Paramedic Practitioners and our Advanced Nurse Practitioner colleagues. This is really important because it frees up GPs to deal with more complex cases.
To illustrate all this I thought I would share my journey with you.
I completed the degree program at Worcester and qualified as a Paramedic in 2012 and subsequently worked on the front line in Wiltshire with South Western Ambulance Service..
After a couple of years I was lucky enough to be selected for a Paramedic Practitioner program which was designed to bridge some of the gaps between emergency and primary care and to ease some of the burden both on hospitals and GPs.
That meant moving to London and whilst I continued to work front line I studied for a BSc in Urgent and Emergency care at St Georges Medical School.
The course involved specialist training and rotational placements in minor injuries, minor health, drug therapies, mental health, paediatrics and geriatrics.
The program culminated with a three-month placement in a GP surgery where I was thoroughly put through my paces by a GP supervisor before finally qualifying.
The journey hasn’t stopped there either.
I subsequently spent four years in an urgent care centre supporting both the 111 service and the emergency department. That gave me a lot of experience dealing directly with hospital specialties, something which has proven invaluable since coming to primary care.
During that period I also completed my training to become an independent prescriber and was one of the first Paramedics in the country to be granted that status.
I’ve also completed an extended training course in analysis and interpretation of blood tests and other diagnostic information.
The next question I suppose is what do we do in primary care?
Well, we’re here primarily to share the GPs workload by dealing with urgent care issues and as a secondary role, to support the nursing staff.
Because of our experience we’re very good at spotting people who are acutely unwell and managing or referring them on either to a GP or to secondary care. We’re also particularly useful for visiting and assessing people who can’t come into the surgery.
Because we’re autonomous clinicians, in many cases we can arrange investigations and tests beforehand so if we do need to refer a patient on to the GP or secondary care, doctors have the information they need before they see the patient. That helps both the patient and the GP by reducing time and freeing up additional appointments.
We can also support the nursing team by managing urgent requests for dressings or taking urgent ECGs or blood samples.
Ultimately that means that patients get a quicker more efficient service.
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