Paramedics working in general practice

There is a shortage of doctors to meet demand in general practice. Other healthcare professionals, including paramedics, are being employed. How do paramedics meet the needs of patients, general practices and the wider NHS? We used realist evaluation to determine what works, for who, and in what circumstances.

We developed interactive tool below for practices to use to discover considerations when employing paramedics as part of their primary care team.

You can also find reports, publications, resources in the published outputs section.

Our paramedics in practice tool

Use this tool to discover the relevant considerations you should make when looking to bring a paramedic into your practice.

Integration How integrated within the team would the paramedic be?

Integration is about the ‘form’ of the service you are planning in terms of how the paramedic(s) fit within the team.

Low integration is when paramedics work across several sites or across different settings (e.g. part-time in the ambulance service). They operate in a ‘satellite’ approach across different sites and only work at your practice for a limited number of sessions each week (<25% of whole time equivalent).

Medium integration is when paramedics work across three to five different surgeries, often with multiple paramedics all working across a few practices. The paramedics are managed and supervised by more than one general practice team.

High integration is when paramedics work at a single practice or up to two surgeries in the same group. They are clinically integrated within the team with practice staff providing their day-to-day supervision.

Complexity How complex would type of patients and conditions managed by paramedics be??

Complexity is the function of the paramedic(s) in terms of the type of patients and conditions they will be required to manage.

Low complexity is same day urgent care, minor illness and/or straightforward routine home visits.

Medium complexity is a mixed scope of practice. For example, one paramedic sees high complexity patients and one paramedic sees low complexity patients. Alternatively, the caseload might be mostly same day urgent care but with some additional specialisation (such as mental health or dementia reviews).

High complexity includes patients receiving palliative care, those with complex diabetes, asthma or frailty or those with safeguarding concerns. Paramedics will take responsibility for a medical episode and are largely autonomous; there are few or no exclusions on the patients they are allocated.