- Dr Sarah Voss (UWE Bristol), Chief Investigator
- Dr Matthew Booker (University of Bristol), Chief Investigator
- Dr Behnaz Schofield (UWE Bristol), Study Coordinator.
General Practice (GP) Services in the UK are under severe pressure and, if demand continues, it is likely there will not be enough GPs to ensure that patients are always seen in a timely way. It is possible that having other practitioners working alongside GPs could reduce the pressure; some GPs are already using paramedics to carry out home visits or see patients with urgent needs.
However, these arrangements have largely arisen on a local level and without evidence to support them. We don’t know the best way to use paramedics in GP Services, if it changes outcomes for patients or if patients are happy be seen in this way.
We will research the different ways that paramedics are already working in GP Services in England and what works best in different situations. The first stage of this research is to find out more information and we will be doing three phases of work.
In phase one, we will investigate the different ways in which paramedics are working with GPs. To do this, we will search the published literature and find other publicly available documents, such as policy documents and job descriptions. In addition, we will carry out a survey of key organisations in the South West, such as GP surgeries; out of hours care providers; Urgent Care Networks and the ambulance service to ask about their experiences of paramedics in primary care and their future plans.
In phase two, we will identify places that have interesting models in place and carry out in-depth interviews to understand how they were intended to work and how they actually work in practice. We will record the interviews and analyse them for themes that are either common between different models or specific to certain ones.
In phase three, we will find out if it is possible to collect relevant data from GP services that will allow us to compare different models of service. For example, can we obtain data on things like the number and case mix of patients seen by paramedics, the duration of the consultation, prescriptions and referrals and the outcome of the consultation? At this stage, we will not analyse the data for differences but we will see how complete this data is and how easy it is to obtain.
At the end of this project, we hope to have a clear picture about the different ways in which paramedics are working in GP services and what works best for patients. We will produce a number of theories about how different models are meant to work in different situations and what they are hoping to achieve. This will lead on to the second stage of the research. We will work with a larger team to produce a research proposal to carry out a ‘realist evaluation’. This would allow us to test the theories with case study sites and obtain data on the effectiveness and costs of different models. This information could be used by the health service for the future planning and delivery of primary care services.