References
Kerbside consultations: advice from the advanced paramedic to the frontline
Abstract
Aim
To observe the issues, benefits and challenges of providing dynamic telephone clinical advice to frontline clinicians by advanced paramedics of the North West Ambulance Service NHS Trust.
Method
In order to focus on the key issues the study used a mixed method approach. A group of 11 advanced paramedics took part in two focus groups which was then followed up with a questionnaire to frontline clinicians. Using focus groups in the research not only allows for the possibility of multiple realities but also for participant validation. Using a qualitative approach allowed theory to develop and emerge which was then codified into themes and the data was then used to develop a questionnaire for frontline clinicians who had received clinical advice in the past in order to provide an element of quantitative data.
Findings
Five themes emerged from the stud: function, responsibility, barriers, education and support.
Conclusion
The study finds that clarity is required in relation to responsibilities and clinicians would benefit from a structured model to communicate information over the telephone—we believe the introduction of remote advice has improved patient safety and support to staff and has created opportunity for additional learning.
Clinical leadership within the ambulance service has been under the spotlight since the publication of Taking Healthcare to the Patient (Department of Health (DH), 2005), which noted the importance of this key function within ambulance trusts. Recommendation 62 stated:
‘…there should be opportunity for career progression, with scope for ambulance professionals to become clinical leaders. While ambulance trusts will always need clinical direction from a variety of specialities, they should develop the potential of their own staff to influence clinical developments and improve and assure quality of care’
‘…there should be opportunity for career progression, with scope for ambulance professionals to become clinical leaders. While ambulance trusts will always need clinical direction from a variety of specialities, they should develop the potential of their own staff to influence clinical developments and improve and assure quality of care’
In 2008, the North West Ambulance Service NHS Trust introduced a new model of clinical leadership into the trust. The organisation adopted the concept of Skills for Health, career framework and set about implementing a variety of leadership roles, including consultant, advanced, senior and specialist paramedics. In 2007, the first consultant paramedic post was appointed, and this was followed in early 2008 with the appointment of 36 advanced paramedics. These clinicians operate 24 hours a day and respond to a variety of calls when senior clinical support may be required such as serious trauma and cardiac arrest. Fundamentally, however, these advanced practitioners are not part of the core operational response model. This allows them the appropriate time to provide the supervision and leadership required to fulfil their role. Part of their responsibilities includes providing remote telephone clinical advice to frontline clinicians.
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