Abstract
INTRODUCTION: The Additional Roles Reimbursement Scheme expands roles, including that of paramedics, and funding into the existing workforce in primary care. This has been laid out in the five-year general practice contract reform framework, with the goal of transforming and evolving the way in which primary care is delivered. Paramedics are rotating from the ambulance service into primary care to help tackle workforce shortages. The aim of this qualitative study was to investigate the experience of those paramedics rotating into primary care from the ambulance service.
METHODS: This qualitative study utilised convenience sampling of paramedics who were on rotation in primary care within one ambulance service. Eight semi-structured interviews took place.
RESULTS: Three key themes of supervision, education and workforce planning were established. Day-to-day supervision was often seen; however, more formal supervision, such as having a designated mentor and completing the first-contact practitioner (FCP) portfolio, was inconsistent. There were clear core skill educational gaps between ambulance paramedics and those that work in primary care. A workforce model, and how this affects the wider system, was discussed, including issues of retention, decision making and referrals.
CONCLUSION: Inconsistent supervision in primary care for FCP roles is evident across disciplines, with physiotherapists acknowledging the same shortcomings. There is a need for more structured support, with access to a mentor / supervision with any FCP role. Within the primary care training period there is a need for a training needs analysis and educational days to support core skills gaps. Due to the positive workforce planning, it is seen that rotations in primary care help to retain staff and have some clear system benefits. To further this, an expansion of the rotations into other areas within the NHS should be considered.