Paramedics in general practice help reduce GP workload but do not contribute to cost savings for the NHS, according to research.
The study published in the British Journal of General Practice (BJGP) looked at the clinical and cost-effectiveness of paramedic compared with GP consultations across 715 patients and 34 practices.
It found that although paramedics in general practice could reduce doctor workload, savings to the NHS were offset by patients’ higher use of non-GP healthcare professionals in the 30 days following initial consultation, including repeat contacts with paramedics.
This may be explained by the finding that patients seen by paramedics in general practice reported lower confidence in health provision.
These patients also reported poorer perceptions of practice engagement in safety promotion and more communication problems with staff immediately after the initial consultation.
Yet the two-year evaluation study by the University of Bristol and the University of the West of England also found there were no differences in patient-reported outcomes and experiences – neither improvement nor deterioration – after 30 days compared with GP consultations.
Researchers recommend further work to understand whether the findings reflect the specific care provided during the paramedic consultation or broader issues in primary care.
Dr Matthew Booker, a GP and consultant senior lecturer in primary care at the University of Bristol’s Centre for Academic Primary Care was one of the lead authors of the study.
He said: ‘Well-designed training and supervision are needed to ensure paramedics have the right knowledge and can clearly convey healthcare plans to patients.’
Co-author Sarah Voss, professor of emergency care at the University of the West of England, said the study was ‘an important first step’ in understanding the impact of consultations by paramedics in general practice.
‘Further research is needed to see whether our findings can be replicated in other primary care settings and to plan how paramedics are deployed, trained and supervised so they can quickly gain the trust of patients that they see,’ said Prof Voss.
The GP surgeries that participated in the study came from a mix of urban, rural, deprived and affluent areas in England, ensuring a diverse representation of general practice sizes and populations.
Based on the findings, the research team has produced a range of materials for both practices and patients.
These include an interactive toolkit for practices to determine how best to configure their services involving paramedics and template patient information leaflets about the role of paramedics in primary care.
The study was funded by the National Institute for Health and Care Research (NIHR).
