Paramedics home visits plan
GPS WHO carry out home visits could soon be replaced by paramedics as part of proposals to change the way primary care is delivered.
In a bid to reduce the workload on these doctors, who often spend many hours a week on community visits, Welsh Ambulance Service advanced practice paramedics (APP) could be available 24-7, all-year round in areas where help is needed.
The proposal, dubbed the “Urgent Home Visiting Service”, was put forward by Betsi Cadwaladr University Health Board (BCUHB) in north Wales and could be given approval this Wednesday.
Similar measures have also been mooted in other parts of the country, including in Cardiff and the Vale of Glamorgan.
It is also hoped such plans would help stop people ending up in hospital accident and emergency departments where resources are stretched to their limits.
A report by BCUHB assistant area director for primary care Wyn Thomas stated: “The proposal is for a 24-7, 365 days a year model of utilising advanced practice paramedics to provide a rapid response service to patients requiring home visits, which would previously have been provided by their GP.
“The service aims to address the immediate health needs of patients that if not seen promptly will end up being an unscheduled care hospital admission.
“This would support GP practices across north Wales in improving the quality of care, transforming the way care is delivered in the community and helping to sustain primary care services, while also reducing emergency admissions.”
The Welsh Ambulance Service said if the scheme is approved, a group of APPs will help out GPs in some areas of the health board which require assistance.
A spokesman for the trust said: “The trust is working collaboratively with Betsi Cadwaladr University Health Board on this initiative which is currently in its early stages and contingent on funding.
“If approved, a group of advanced paramedic practitioners will help to support primary care providers in some areas of north Wales where practices require assistance.
“We are committed to widening our clinical offer and will continue to work with the health board and other partners on system solutions that ultimately support patients.”
According to latest data from the Royal College of GPs, there were 1,926 GPs employed in Wales in 2017-18 – the lowest number in a decade.
Dr Rebecca Payne, chairwoman of the Royal College of GPs in Wales, said she would support such a proposal.
She said: “We welcome initiatives that allow paramedics to work alongside GPs and other healthcare professionals, delivering care in people’s communities.
“It is encouraging that Betsi Cadwaladr are recognising the crisis in GP numbers and are taking practical steps in order to continue to provide care to patients.
“We should be absolutely clear that this cannot be seen as a substitute for boosting the GP workforce.
“Just last week we saw figures that said the number of GP practitioners is the lowest it has been in a decade.
“General practice will remain at the heart of primary care and the challenges facing our profession need addressing.
“Paramedics aren’t GPs, and there would be training, support and supervision needs to make this work.
“However, it is part of an evolving model which we hope will allow support for GPs to ensure continuing patient care.”
In 2015-16 the Welsh Government announced additional funding to support “tangible and measurable” change in how primary care was delivered.
The emphasis was on shifting services out of hospital settings and into community settings wherever possible.
In addition to paramedics, pharmacists, physiotherapists and nurses have also been used in more primary care settings.
A Welsh Government spokeswoman said: “We welcome action by BCUHB to test new and innovative ways of providing timely care to meet people’s urgent needs at home and to avoid inappropriate emergency admissions to hospital based care.”