How employing a paramedic solved our recruitment problem
When Dr Jonathan Cope’s practice failed to recruit new staff to conventional roles, it employed a paramedic to help with triage and patient assessment
Like many practices around the country, we were short-staffed and had no applications for jobs we advertised. So we decided that our practice - a partnership of three merged practices in south Devon serving 33,000 patients - needed an alternative solution to keep it afloat.
What we did
I first met our paramedic, Simon, when he came to the practice to update me on one of my frail elderly patients to whom he had been called out. He had done an excellent job and I kept his contact details.
When our practice decided to look for other skills to fill the gaps we had, I thought of Simon. He was surprised when we proposed he join our team, but keen to explore the idea. After meeting the other GPs, who were equally impressed with him, he started working for us in May on the equivalent of an AfC Band 8 pay grade.
He works alongside a nurse practitioner and a pharmacist as part of a rapid assessment team dealing with on-the-day urgent appointments.
Receptionists triage calls for same-day appointments to the members of the rapid assessment team, trying to match callers to the team member with a skill set most suited to their complaint.
Simon works from 8am until 6pm. His first hour is spent calling back patients who have asked to be seen that day, offering advice over the phone or inviting patients in for face-to-face appointments if necessary. He deals with presentations such as chest pain, palpitations, pneumonia and infections in children, as he is used to dealing with emergency health issues.
He also does roughly two home visits a day; his paramedic background means he is confident going into people’s houses and looking at environmental factors that might be contributing to their illnesses.
If you hire a paramedic you are offering them another avenue for professional development and the opportunity to learn more clinical skills. Simon has protected time for educational support, which he wouldn’t get with the ambulance trust, and a working life compatible with having a young family, instead of night shifts.
One barrier for the practice was that Simon was hard to insure. The Medical and Dental Defence Union of Scotland will recognise the nurse practitioner role, but not the role of paramedic, so we had to have separate indemnity for him. Also, Simon can’t prescribe until paramedics are recognised as a professional group, which we hope will happen some time next year. In the meantime, he has to run prescriptions past one of the GPs.
The practice hasn’t had any negative feedback from patients - indeed, they have started to ask specifically to be seen by Simon for ‘urgent’ problems.
He has brought new skills in triage, minor injury and patient assessment. He has also provided training in resuscitation and catheter changing, which we previously had to buy in.
All in all, our rapid assessment team takes a huge amount of pressure off the duty doctor. GPs have seen in two months a 30-40% reduction in calls and home visits. Being on duty used to be something you would dread and it could be a very long day. Now, although it’s still busy, it is manageable.
Hiring a paramedic is worth serious consideration, especially for larger practices or those in more rural areas.
Dr Jonathan Cope is a GP in Ivybridge and managing partner at the Beacon Medical Group in South Devon