Setting the scene for paramedics in general practice: What can we expect?

Primary care services in England may be reaching saturation point. Demands to see a GP or practice nurse have increased substantially. Clinical complexity has also increased; patients are living longer, but with more multimorbidity.(1) These demands are mirrored by a decline in the GP workforce, despite political pledges to reverse this.(2) New strategies are needed to tackle the current pressures in general practice and reduce the risks of harm to patients. The NHS England GP Forward View advocates investing and developing new models of care, including expansion of a multidisciplinary, integrated primary care team.(3) These recommendations reflect the findings of the Primary Care Workforce Commission, who highlighted the potential roles for clinical pharmacists, physician associates, and physiotherapists, all substituting into current GP care pathways.(4) The Commission also recommended that general practices should consider more opportunities to use the skills of paramedics in primary care. Specific roles may include running clinics, triaging and managing minor illnesses, as well as provide continuity for patients with complex health needs. Further roles may include assessment and management of requests for same-day urgent home visits, as well as regular visits to homebound patients with long-term conditions.The commision highlighted that these innovative roles should be subject to further evaluation. Nevertheless, historical and current perspectives allow us to model how the role could be fully used.