Primary Care Paramedic
Central Medical Services are working in Partnership with North Norfolk Primary care to provide both qualified and trainee Primary Care Paramedics
Central Medical services are working in partnership with North Norfolk Primary Care to provide Primary Care Paramedics to support GP surgeries across the county.
Working alongside a multi-disciplinary team including Doctors, Nurses and HCA’s, our paramedics will be diagnosing and treating patients presenting with minor illness and injury, chronic disease management, on the day presentations as well as home visits.
The general daily tasks can involve walk in clinics to community home visits and phone triage. Front line, 999 duties are also part of the role to keep up to date with your core paramedic skills.
The role of Primary Care Paramedic, is to support GP practices in delivering their service and duties to patients.
Practitioners will be split by location and will work across the North Norfolk area. The paramedic has access to the full GP records and will work within the community, as an independent, responsible, Advanced Paramedic Practitioner, as well as within the surgery itself. They will assess, diagnose, treat, refer, and signpost patients or service users who attend the Practice with undifferentiated or undiagnosed conditions relating to minor illness or minor injury.
This is a development role that includes multiple learning opportunities to become a Primary Care Paramedic undertaking a Level 7 MSc with Nottingham Trent University for 1 year. Upon successful completion of the MSC we aim to develop the paramedics knowledge and skills further by including additional courses as part of this role which include subjects such as Independent Prescribing and x-ray interpretation, ultrasound amongst others.
CMS are excited to be starting this journey with the Primary Care Networks of NN1, NN2, NN3 and NN4.
A day in the life...
A typical day will look like this:
See the duty doctor of the practice you are based in and see what the triage list looks like today. You will ring around the other practices, all of whom you are well known by, to see how their visit list is looking.
You may help with triaging some of the patient requests that have come via the practice’s website.
Patients requiring home visits across your practices are added to an electronic list on the GP clinical system. You prioritise your visits, plan a route, and head out. You take a mobile-enabled laptop with you so that you have access to all their records, drugs, results, and care plans. Your notes are typed up after each patient and you have live access to the visit list.
After a bite to eat (no being given a 999 call to take you off your break) you see some booked on-the-day patients in the surgery. Because you are helping the duty doctor and duty nurse they are very glad to see you!
This might be someone with a wound that needs cleaning and steri-stripping, someone who is ambulant with a possible urinary tract infection, or someone needing an ECG to confirm a pain is musculo-skeletal. These appointments are likely to be about 15-minutes each, many you will be able to see and treat yourself, but others may require sending an electronic task for follow-up by a GP, a long term conditions nurse, or another member of the MDT.
Back out on home visits. Each one will take about half an hour. These are patients that so easily could end up in hospital because of the time of day. You are used to assessing the risk of somebody being safe to remain at home, but you learn that clinicians in general practice act very autonomously (there is always someone to ask), at quite a fast pace (GPs are used to 10-minute appointments), but as part of a trusted and close-knit practice team.
It is time to head home. No night shifts in general practice!
Typical cases in general practice
A husband and wife in their early 90’s who cannot get out and whose family live a long way away.
The husband is complaining of a cough and is getting through a bottle of GTN every two days – it does not sound cardiac on the phone but they are not great historians.
The wife has swollen legs but no shortness of breath, though is struggling to be able to move around and has a history of falls. You use your well-honed paramedic assessment skills to determine that the husband has a chest infection and is not using his GTN appropriately.
The wife needs to elevate her legs and a temporary adjustment of the dose of her diuretics.
This couple are well known to the GP and you have all their records in front of you. You can call the GP to quickly describe your assessment, your suggested management plan, and confirm that it is safe to leave the couple at home.
You might go back the following day to check they are improving.
A carer at a care home rings the surgery saying a resident has a temperature. They are not trained to undertake a urinalysis or listen to a chest.
You get there and find it is a wound that is the source of infection.
You initiate antibiotics, perhaps under PGD or in time you prescribe, and make a referral through to the Enhanced Care Home team to follow up.
You give advice to the care home staff about the signs of deterioration and sepsis, and what to do if it is out-of-hours.
Whilst you are seeing patients in the surgery, a daughter brings her 80-year old mother in the car without an appointment.
The receptionists shout because they cannot get her out of the car. You quickly realise that she has a slight facial droop and weakness in her left side. You coordinate the reception team to get her inside to the treatment room where you undertake a comprehensive assessment and liaise with ambulance control to get her transported to hospital.
Because of our rurality, this can take some time so you are quite happy to continue monitoring her without needing to take the duty GP away from their long list of patients.