The PCN must ensure that each paramedic has the following key responsibilities:
- They will work as part of a multi-disciplinary team (MDT) within the PCN.
- They will assess and triage patients, including same day triage, and as appropriate provide definitive treatment (including prescribing medications following policy, patient group directives, NICE (national) and local clinical guidelines and local care pathways) or make necessary referrals to other members of the primary care team.
- They will advise patients on general healthcare and promote self management where appropriate, including signposting patients to the PCN’s social prescribing service, and where appropriate, other community or voluntary services.
- They will be able to:
- - perform specialist health checks and reviews within their scope of practice and in line with local and national guidance
- - perform and interpret ECGs
- - perform investigatory procedures as required, and
- - undertake the collection of pathological specimens including intravenous blood samples, swabs, and other samples within their scope of practice, and within line of local and national guidance.
- They will support the delivery of ‘anticipatory care plans’ and lead certain services (e.g. monitoring blood pressure and diabetes risk of elderly patients).
- They will provide an alternative model to urgent and same day GP home visit for the network.
- They will communicate at all levels across organisations ensuring that an effective, person-centred service is delivered.
- They will communicate proactively and effectively with all colleagues across the multi-disciplinary team, attending and contributing to meetings as required.
- They will maintain accurate and contemporaneous health records appropriate to the consultation, ensuring accurate completion of all necessary documentation associated with patient health care and registration with the practice.
- Communicate effectively with patients, and where appropriate family members and their carers, where applicable, complex and sensitive information regarding their physical health needs, results, findings, and treatment choices.
Capabilities across Band 7 and Band 8a (AfC) in Primary Care.
First Contact Practitioner Band 7
• Manages undifferentiated undiagnosed conditions
• Able to identify red flags and underlying serious pathology and take appropriate action
• Works within practice, acrossPCN, multi-organisational, cross professions and across carepathways and systems including health, social care, and the the voluntary sectors
• High level complex decision making to inform the diagnosis,investigation, management,and on referral within scope of practice
• Actively takes a personalised care approach to enable shared decision making with the presenting person
• Contributes to audit and research projects
• Contributes to education and supervision within their scope of practice for the multi-professional team
• Facilitates interprofessional learning in area of expertise
• Promotes and develops area of expertise across care pathways
• Working toward Advanced Clinical Practice (level 7 across all 4 pillars)
Advanced Clinical Practitioner Band 8a
• Manages undifferentiated undiagnosed conditions
• Able to identify red flags and underlying serious pathology and take appropriate action
• Works within practice, across PCN, CCG andICS, multi organisational, cross professionals and across care pathways and systems including health, social care, and the voluntary sectors
• High-level of complex decision making to inform diagnosis, investigation complete management of episodes of care within a broad scope of practice
• Flexible skill set to adapt to and meet needs of the PCN Population and support public health
• Manages medical complexity
• Actively takes a personalised care and population centered care approach to enable shared decision making with the presenting person
• Actively engages in care from a Population careviewpoint
• Leads audit and research projects
• Leading audit within areas of capability
• Provides multi-professional AP clinical and CPD supervision across all four pillars with relevant training
• Leads education in their area of expertise
• Enables, facilitates, and supports change across care pathways and traditional boundaries
• Working toward level 8
Where a paramedic is not working at academic Level 7 capability, the PCN must ensure that they are working as part of a rotational model in which they have access to regular supervision and support. We encourage PCNs to work with their systems and local ambulance trusts to come to an arrangement that ensures that the paramedic is operating within the scope of their competency.
The Paramedic Specialsit in Primary and Urgent Care Core Capabilities Framework here.
e-Learning for Healthcare
The following resources can be accessed via e-Learning for Healthcare (e-LfH). E-LfH provides free e-learning programmes which can support you in your professional development.
If you do not already have an account, click here to register using your NHS email address. If you already have an account, please use the same link to firstly log in to access the following resources.
The below resources are available to support Allied Health Professionals in their understanding and their development:
- Allied Health Professional Careers Resource: The AHP Careers Resource takes eight potential areas for career development, the resource provides a wealth of information to highlight the wide range of available option, all whilst continuing to work clinically if desired. AHP colleagues taking different career journeys from across the 14 disciplines appear on film and share what has helped, what barriers they have overcome, and what they enjoy most about their work.
- The Wow Show: A video resource that introduces you to individuals in AHP roles within the NHS to give an understanding of their roles and their experiences.
- Resources for AHP in a primary or community setting This package provides training materials and resources useful to Allied Health Professionals working in a primary care or community setting during the current COVID-19 pandemic. It covers a comprehensive set of topics including breathlessness, fatigue, mobility and function, and includes resources for paramedics.
The below resources are specific to a paramedic in practice and provide role specific support and guidance:
- Pathology: This course provides added value material to support the training of medical and healthcare science trainees in seven main specialties: histopathology, haematology, microbiology, chemical pathology, virology, immunology and genetics.
- Population Health Management: This course aims to equip learners with the basic knowledge required to understand what is meant by population health management, drawing on case studies to bring this to life.
- Introduction to Public Health: This session will explore the meaning of the term ‘public health’ and consider how public health has evolved over time. Later, it will identify the various domains of public health and examine the role of paramedics in supporting public health
- Paramedics Programme: This programme covers a range of the responsibilities of a paramedic through bite-sized interactive courses.
Health Education England e-learning for healthcare (HEE elfh) worked in partnership with the College of Paramedics to develop 2 new sessions in the Long Term Conditions for Paramedics module. The module has been developed to support paramedics knowledge and skills in treating and managing long term conditions.
The new sessions are Chronic Obstructive Pulmonary Disease and Heart Failure.
Existing sessions include, but are not limited to
- Asthma
- Diabetes
- Epilepsy
- Heart Failure
- Living with Stroke
- Why Falls and Frailty Matter
If working towards Advanced Clinical Practitioner, you may also wish to review the below.
- The Advanced Practice Toolkit has been created as a repository for consistent, credible and helpful resources relating to Advanced Practice.
The below resources support with the Leadership and Management Pillar of Advanced Practice:
The below resources support with the Research Pillar of Advanced Practice:
A further useful resource is Supervision for Multi-Professional Teams, which will provide Advanced Practitioners support with supervision of CPD across all four pillars.
These lists are not exhaustive and the programmes available are regularly updated, so we recommend visiting the e-LfH portal and reviewing the available resources via using the “View full catalogue” function, or the “Search the e-learning" function.
If you currently work in primary care, and have found e-learning resources that were helpful, and were not included on the above lists, please let us know on traininghub.nenc@hee.nhs.uk and we will update this resource so that it can be of use to others.
Clinical Supervision of Paramedics can be conducted by:
- Experienced Paramedic
- GP
- ACP (3+ years)
Roadmap Supervisors
- HEE recognised Roadmap Supervisors are being trained by HEE Roadmap National Trainers or are existing GP educational supervisors.
- As detailed in the roadmap each practitioners will require 2 workplace based assessments (WPBA) per month which will take on average a total of 45-60 minutes to complete both. In addition to the WPBA there will be at least a daily debrief of approximately 20-30 minutes in length.
- Some debrief can be done remotely if the ‘debriefer’ has access to the patient record – eg. phone/teams
- Each full-time equivalent Roadmap supervisor can supervise up to four practitioners at a time.
Portfolio of evidence
- As a practitioner who is working in primary care seeing undifferentiated and undiagnosed presentations it is key to ensure patient and practitioner safety.
- Having a portfolio of triangulated evidence against agreed capabilities is a robust method of evidencing capability. The development of a portfolio of evidence is the responsibility of the practitioner but they should have the support of a supervisor.
- Editable PDF versions of the portfolio tools will be added to the Landing Page for stage two.
Stage one
- The evidence for stage one should demonstrate capability against the knowledge, skills and attributes (KSA) in the profession specific Roadmap. Stage one needs to demonstrate level 7 knowledge, complex clinical reasoning, and critical thinking.
- Any level 7 modules/credits can be mapped across and any learning outcomes from the modules will help this process. It is likely a practitioner will require 5 pieces of reflection to show currency of their KSA in daily practice.
- On the landing page there is a video explain how to evidence level 7 KSA. Examples of reflective writing will be added soon.
Stage two
- The portfolio of evidence for stage 2 must use the portfolio tools in the framework otherwise the evidence will not be valid. Each Roadmap has a table of requirements for stage 2.
- One learning log reflection a week would build up evidence of application of knowledge and skills in everyday practice. Work-place based assessments (WPBA) provide an assessment of capability by a trained Roadmap supervisor.
- One COT & one CBD per month is stated in the roadmap and this should take an average of 45-60 minutes a month.
- Feedback from patients/the public and the primary care team also provide evidence for your portfolio. The portfolio tools with guidance how to use them is included in the Roadmap appendices.
To become a paramedic, a degree/diploma level in Paramedic Science or equivalent experience and registration with the Health and Care Professions Council (HCPC) is required.
Local providers of BSc in Paramedic Science:
On successful completion of this course you will be eligible to apply for registration with the HCPC as a paramedic.
The College of Parademics provides a full list of endorsed courses.
Training requirements
1. Where a PCN engages a paramedic to work in primary care under the Additional Roles Reimbursement Scheme, the PCN must ensure that the paramedic:
a. is educated to degree/diploma level in Paramedicine or equivalent experience
b. is registered with the Health and Care Professions Council (HCPC)
c. has completed their two-year ‘Consolidation of Learning’ period as a “newly qualified paramedic”
d. has a further three years’ experience as a band 6 (or equivalent) paramedic
e. is working towards developing Level 7 capability in paramedic areas of practice and, within six months of the commencement of reimbursement for that individual (or a longer time period as agreed with the commissioner), has completed and been signed off formally within the clinical pillar competencies of the Advanced Clinical Practice Framework.
100% of actual salary plus defined on-costs, up to the maximum reimbursable amount of £60,401 over 12 months.
Professional Body Resources
The College of Paramedics is the professional body for paramedics in the UK, leading the development of the profession across a wide range of health and care settings. This provides a career framework, an events calendar along with other useful resources.
This resource from HCPC provides guidance around the expectations, scope of practice and standards of a Paramedic.
Role Overview
This resource provides a summary of the working life, entry requirements, training and career development of a paramedic, using real life examples.
This updated DES outlines the role of the paramedic and what is expected from the PCN (page 103-105).
HEE have compiled a resource to give an overview of the role of paramedics in urgent and emergency care.
HEE have provided this resource to cover the most common areas that Paramedics support with in primary care.
Employer Resources
This resource is for those looking to recruit paramedics and explains the role, pre requisites, supervision and various other aspects of a paramedic in primary care's role.
This document is aimed at general practices and ambulance services to improve understanding of the roles and responsibilities of general practice paramedics. It includes information on education/development needs, supervision requirements and the differences between enhanced, first contact and advanced levels of practice.
Relevant Research
The Kings Fund have conducted research around four ARRS roles including Paramedics, to address the experiences of people working in these roles, and the people managing them, to address any lack of understanding and ambiguity. Read the short summary here.
Career Pathway
This document provides a roadmap of education for practice when moving into First Contact Practitioner (FCP) roles, and onward to Advanced Practice (AP) roles in Primary Care.
This document provides clarity around implementing the FCP/AP roadmap into practice.
Jobs
If you are looking for a new position related to this role, we recommend checking both NHS Jobs and HealthjobsUK.
NHS Jobs is the official online recruitment service for the NHS in England and Wales, with over 30,000 jobs posted every month.
Hosted by trac.jobs, HealthJobsUK is among the leading job boards in the health and public sector within the UK.
