References

Abrams R, Wong G, Mahtani KR Delegating home visits in general practice: a realist review on the impact on GP workload and patient care. Br J Gen Pract. 2020; 70:(695)e412-e420 https://doi.org/10.3399/bjgp20X710153

Baird B, Charles A, Honeyman M, Maguire D, Das P. Understanding pressures in general practice.London: The King's Fund; 2016

Bench S, Baker E, Dover N, Garry B, Nwosu W, Peacock S, Trenchard-Turner N, Whaley S, Worth T, Lee GA. The education and training needs of advanced clinical practitioners: an exploratory, qualitative study. J Nurs Educ Pract. 2018; 8:(8)66-74 https://doi.org/10.5430/jnep.v8n8p66

British Medical Association. Do I need to do home visits?. 2020. https//tinyurl.com/328wvjcp (accessed 15 May 2021)

Booker M, Voss S. Models of paramedic involvement in general practice. Br J Gen Pract. 2019; 69:(687)477-478 https://doi.org/10.3399/bjgp19X705605

Care Quality Commission. GP mythbuster 71: prioritising home visits. 2021. https//tinyurl.com/c4f4xv7e (accessed 25 May 2021)

A day in the life of a GP. 2016. https//tinyurl.com/c6dm (accessed 15 May 2021)

College of Paramedics. College of Paramedics strategy 2019–2024. 2019. https//tinyurl.com/2kemscue (accessed 15 May 2021)

College of Paramedics. Employers' guide. Paramedics in primary and urgent care. 2019. https//tinyurl.com/y4et73uf (accessed 15 May 2021)

Taking healthcare to the patient: transforming NHS ambulance services.London: DHSC; 2005

Department of Health and Social Care. NHS Constitution. The principles and values of the NHS in England. 2012. https//tinyurl.com/2r8sfs6s (accessed 15 May 2021)

de Hoon SEM, Hek K, van Dijk L, Verheij RA. Adverse events recording in electronic health record systems in primary care. BMC Med Inform Decis Mak. 2017; 17:(1) https://doi.org/10.1186/s12911-017-0565-7

Detheridge A. Investigating staff perceptions and experiences of telephone triage in general practice. Pract Nurs. 2020; 31:(9)383-389 https://doi.org/10.12968/pnur.2020.31.9.383

Dixon M. A paramedic journey to non-medical prescribing: part 3. J Paramedic Pract. 2019; 11:(12) https://doi.org/10.12968/jpar.2019.11.12.541

Eaton G, Wong G, Williams V, Roberts N, Mahtani KR. Contribution of paramedics in primary and urgent care: a systematic review. Br J Gen Pract. 2020; 70:(695)e421-e426 https://doi.org/10.3399/bjgp20X709877

EMIS. EMIS Web. Benefits. 2021. https//www.emishealth.com/products/emis-web/ (accessed 15 May 2021)

Fenn P, Egan T. Risk management in the NHS: governance, finance and clinical risk. Clin Med (Lond). 2012; 12:(1)25-28 https://doi.org/10.7861/clinmedicine.12-1-25

Ferguson H. Making home visits: creativity and the embodied practices of home visiting in social work and child protection. Qual Soc Work. 2018; 17:(1)65-80 https://doi.org/10.1177/1473325016656751

Givati A, Markham C, Street K. The bargaining of professionalism in emergency care practice: NHS paramedics and higher education. Adv Health Sci Educ Theory Pract. 2018; 23:(2)353-369 https://doi.org/10.1007/s10459-017-9802-1

Health and Care Professions Council. Advanced practice final independent research report. 2021. https//www.hcpc-uk.org/resources/policy/advanced-practice-full-research-report/ (accessed 25 May 2021)

Health and Care Professions Council. Record keeping. 2021. https//tinyurl.com/ajrb75xj (accessed 15 May 2021)

Health Education England. What is advanced clinical practice?. 2017. https//www.hee.nhs.uk/our-work/advanced-clinical-practice (accessed 15 May 2021)

Iliopoulos E, Morrisey N, Baryeh K, Polyzois I. Correlation between workplace learning and job satisfaction of NHS healthcare professionals. Br J Healthc Manage. 2018; 24:(5)226-233 https://doi.org/10.12968/bjhc.2018.24.5.226

Innes JA, Dover AR, Fairhurst K. Macleod's clinical examination, 14th edn. London: Elsevier; 2018

Japp AG, Robertson C. Macleod's clinical diagnosis, 2nd edn. London: Elsevier; 2018

NHS Constitution.

NHS England. Transforming urgent and emergency care services in England. Urgent and emergency care review. End of phase 1 report. 2013. https//tinyurl.com/265chyy5 (accessed 15 May 2021)

Iacobucci G. GPs call for home visits to be removed from contract. BMJ. 2019; 367 https://doi.org/10.1136/bmj.l6663

Mitchell S, Hillman S, Rapley D, Gray SDP, Dale J. GP home visits: essential patient care or disposable relic?. Br J Gen Pract. 2020; 70:(695)306-307 https://doi.org/10.3399/bjgp20X710345

National Institute for Health and Care Excellence. Chapter 6. GP-led home visits. 2018. https//tinyurl.com/enbnywb5 (accessed 15 May 2021)

Newton A, Hunt B, Williams J. The paramedic profession: disruptive innovation and barriers to further progress. J Paramedic Pract. 2020; 12:(4)138-148 https://doi.org/10.12968/jpar.2020.12.4.138

NHS England. Five year forward view. 2014. https//tinyurl.com/r69x4wsm (accessed 15 May 2021)

NHS England. Risk of death from failure to prioritise home visits in general practice. 2016. https//tinyurl.com/9dzh2dnu (accessed 15 May 2021)

NHS England. The NHS long term plan. 2019. https//tinyurl.com/hddx7yp3 (accessed 15 May 2021)

O'Meara P, Wingrove G, Nolan M. Clinical leadership in paramedic services: a narrative synthesis. International Journal of Health Governance. 2017; 22:(4) https://doi.org/10.1108/IJHG-03-2017-0014

Pearson X. The clinical governance of multidisciplinary care. Int J Health Govern. 2017; 22:(4)246-250

Proctor A. Home visits from paramedic practitioners in general practice: patient perceptions. J Paramedic Pract. 2019; 11:(3)115-121 https://doi.org/10.12968/jpar.2019.11.3.115

Salisbury H. Helen Salisbury: why I resist giving up home visits. BMJ. 2019; 367 https://doi.org/10.1136/bmj.l6618

Schofield B, Voss S, Proctor A Exploring how paramedics are deployed in general practice and the perceived benefits and drawbacks: a mixed-methods scoping study. BJGP Open. 2020; 4:(2) https://doi.org/10.3399/bjgpopen20X101037

Skills for Health. Paramedic specialist in primary and urgent care (2019). 2019. https//tinyurl.com/ft43jv9c (accessed 15 May 2021)

An opportunity to future-proof the primary care workforce?. 2020. https//tinyurl.com/2mbftkbb (accessed 15 May 2021)

Theile G, Kruschinski C, Buck M, Müller CA, Hummers-Pradier E. Home visits—central to primary care, tradition or an obligation? A qualitative study. BMC Fam Pract. 2011; 12 https://doi.org/10.1186/1471-2296-12-24

Van Zwanenburg T, Harrison J. Clinical governance in primary care.Boca Raton (FL): CRC Press; 2018

Winter K, Cree VE. Social work home visits to children and families in the UK: a Foucauldian perspective. Br J Soc Work. 2016; 46:(5)1175-1190 https://doi.org/10.1093/bjsw/bcv069

World Health Organization. Topic 6. Understanding and managing clinical risk. 2009. https//apps.who.int/iris/handle/10665/330066 (accessed 25 May 2021)

Paramedic-led acute home visiting services in primary care

02 June 2021
Volume 13 · Issue 6

Abstract

Home visiting is traditionally carried out by GPs but it is becoming increasingly difficult for GPs to do, and many doctors want it removed from their contract. This is opening up a space for the paramedic profession, with paramedics carrying out home visits and designing future primary care services. Paramedics working within primary care can possess the knowledge, leadership and complex skills needed for home visiting, and some are independent prescribers; they can lead acute home visiting services (AHVS). AHVS require effective triage and access to electronic patient records, are underpinned by robust clinical governance and engage in clinical audits. Future primary care paramedic services could include online, video and face-to-face consultations, care home ward rounds, remote triage and home visiting. However, paramedics' contribution to general practice has not been fully evaluated and it may take time for this to become a norm. Regardless, primary care paramedicine has an opportunity to be innovative, shaking off risk-averse protocols for more enlightened practices, and lead the profession.

Home visiting is an unpredictable activity with an unknown outcome for health professionals. Ferguson (2018) states that home visiting constitutes a distinct sphere of practice and experience in its own right, as it is a deeply embodied practice in which all the senses and emotions come into play; practitioners apply home visits by skilfully enacting a series of transitions from the office to the doorstep, then into the house, where complex interactions with service users and their domestic space occur. Winter and Cree (2015) relayed the idea of home visiting as an ‘invisible trade’, as it happens behind closed doors in the most secret, intimate spaces of people's lives.

An advantage of home visiting is that practitioners witness patients' first hand in their own innate surroundings, which can uncover health and social care needs of ill and vulnerable people. Home visiting discloses many aspects of people's way of life and can stimulate wider thought processes for practitioners in comparison with consulting in the static confinement of hospitals or medical centres.

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