Rotating paramedics – getting the right response, first time

14 May 2018
Providing the right response, first time to people in need of urgent care has the exciting prospect of improving patient care, whilst significantly reducing demand on ambulance and other NHS services. That’s the aim of the Health Education England (HEE) rotating paramedic model, currently being piloted by four ambulance services in England, in collaboration with community and primary care colleagues.
Developed with input from NHS organisations and individuals working in the urgent and emergency care sector, the rotating paramedic model offers a radically different approach to system working. Paramedics working in settings outside the ambulance service is certainly not new, but ambulance services and primary care together supporting a rotational model of working through each care setting, with central support is different and that’s what’s being piloted and evaluated in the HEE programme.
The rotational model of working involves specialist or advanced paramedics rotating into, and contributing to, the following areas:

The pilot is expected to produce the following results.
• More patients, many with multiple and complex conditions, receive the right care,first time - safely managed in their own homes or in the community
• The ambulance service has increased capacity to respond to calls that are life-threatening
• General practice has an extra resource to immediately relieve workload pressure and reduce impact on ambulance and secondary care
• The community team’s workload is supported by an extra generalist resource in the form of a specialist or advanced paramedic increasing capacity to provide the most appropriate response, first time to 999 calls and to provide proactive care within their community
• Partnerships are built across the system with shared responsibility for population health.
Commenting on the results so far, Rhian Monteith, clinical lead for the rotating paramedic pilot, Health Education England said: “Early case studies and data from the pilot sites show that the paramedics are reducing avoidable trips to A&E and associated admissions; and increasing capacity within primary care by undertaking acute home visits on behalf of GPs.
“There has been excellent engagement, commitment and enthusiasm from everyone involved, including the ambulance service, primary care colleagues and community providers,” said Rhian.
“Once the evaluation is complete, we will be looking to see how the model could be commissioned and rolled out as part of an integrated urgent care system.”


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