Joanna Blodgett, Duncan Robertson, David Ratcliffe, Kenneth Rockwood
Journal of Paramedic Practice, Vol. 9, Iss. 1, 06 Jan 2017, pp 11 - 17

An innovative policy implemented by a UK Ambulance Service allows paramedics
to refer patients to a GP Acute Visiting Service scheme. Initial evidence suggests
that this alternate route of care can decrease hospital admission rates, decrease
A&E waiting time and provide substantial savings for the NHS. However,
there are many unrecognised barriers to referral that are not captured by the
quantitative analysis. The goal of this qualitative-observational study was to gain
insight into the GP referral scheme from a paramedic's perspective. All notes
were transcribed, coded and analysed using a Grounded Theory approach. Four
main themes emerged: 1) barriers to referral including wait time, process, and
lack of confidence, experience and training 2) approaching the patient with
the GP referral scheme in mind 3) frustrations with GP decision making and 4)
awareness/understanding of the scheme's impacts. This study provided valuable
insight into the paramedic's perspective of the GP referral scheme. Maximising
understanding of the scheme, investigating the GP's perspective in decision
making and ensuring knowledge and accountability of paramedics, GPs and the
public were identified as solutions to strengthen and increase referral rates and
scheme success.

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