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How your practice can save £20K by making better use of paramedics

3 April 2018

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Adelaide Street Surgery in Blackpool was struggling to hire more GPs to meet a growing demand of appointments from its patients.
The practice management team and GP partners met to come up with a workforce strategy, which resulted in the decision to hire two paramedics.
The move came after a positive experience in 2015, when the practice hired its first paramedic to deal with acute on the day emergencies.
On top of being able to save £20,000 a year, the team could offer an extra 88 appointments per week.
Management in Practice’s reporter Valeria Fiore talked to the practice business manager, Luan Stewart, to find out how they have done it.
The problem
There is a national shortage of GPs and Blackpool is one of the difficult to recruit areas and the problem identified was highlighted by a lack of available appointments for patients. Therefore, innovative ways of working needed to be found to work smart with the issues at hand and find a new way to ensure that our patients were seen in a timely fashion by a suitable health care professional.
Recruitment for a new salaried GP in 2010 for a similar size practice in the local area yielded over 50 applicants. A similar longstanding advert for the surgery in 2016 resulted in no suitable applicants. Alternative solutions needed to be explored.
The solution
We are in a deprived and transient area, which creates a need for many on the day acute appointments.
Hiring a paramedic practitioner was considered, with the awareness that they could assist with acute on the day appointments and visits.
Paramedics were not widely used in GP settings. We understood that GP time would be taken for every session to mentor and train the new staffing role and this would be on-going for at least 12 months. As a training practice, we felt well-equipped to offer that level of mentorship.
We chose two applicants to start in August 2016.
The challenges
It has taken admin staff a little time to get used to who can see what type of problems and they have to ask more probing questions to patients booking appointments, which at first some patients were not happy to answer. However, being able to see a clinician quickly helped them open up to the questions asked, and they have commented favourably about seeing paramedics.
The biggest challenge is finding the time for GPs to mentor and train paramedics whilst also running their own clinics, seeing patients and organizing paperwork. 
The benefits
This project will now become routine practice as it increases capacity and is a good financial decision. If we recruit again, we will then be in a position for the long standing paramedics to be able to offer some joint mentorship to any new paramedics, alongside GP mentorship.
We were able to recruit two full time paramedic practitioners offering a total of 20 clinical sessions per week. They manage to see 20 patients a day in 15 minute appointments.
Their combined annual salaries are in the range of £80,000. This decision offered better value for money, as one salaried GP would provide eight sessions per week at an annual cost of approximately £100,000. Therefore, we saved £20,000 but doubled the capacity of appointments available.
‘Paramedics are much more used to dealing with the on-the-day emergencies because that’s their role in their previous positions. It made sense to have someone to come and deal with the acute appointments and also the home visits because that’s what they know.
‘It’s meant we have a lot more appointments for the GPs over our two sites. It assists the GPs with the visits which frees up their time to see more people in their morning and afternoon clinics and to catch up with their paperwork.’
Picture credit: Adelaide Street Surgery

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