Non-medical prescribing for paramedics in primary care

In recent years, paramedics have branched out from their roots as ambulance clinicians and are now working in a variety of settings, including primary care. A figure from NHS Digital (2020) suggests that 837 paramedics were employed in primary care in March 2020, increased from 569 the previous year. This growing figure illustrates the increasing importance of prescribing and medicines management in primary care. In general, the paramedic works as an independent practitioner and, while in the ambulance setting, the traditional medicines management frameworks proved adequate, they were left lacking in general practice. The paramedic medicines exemptions (HM Government, 2012) apply only to a select few medications relevant to emergency and urgent care. While a potential solution in some settings, patient group directions (PGDs) take time and effort to set up and suffer from being unable to extend to the broader requirements of primary care. Indeed, where possible, the National Institute for Health and Care Excellence (NICE) (2017) recommends increasing prescriber numbers to avoid using PGDs.