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The role of paramedics with extended practice: exploring the healthcare context

08 October 2012
Features
02 October 2012
Volume 4 · Issue 10

Abstract

With National Health Service (NHS) providers facing the challenge of measurement through clinical outcomes, measures of effective service provision, this article explores the political influences; background and current approaches which have expanded paramedics’ scope of practice.As there are conflicting demands upon ambulance service NHS trusts provision of healthcare, these features are related to experiences within the London Ambulance Service, and where relevant to national experiences.

The educational requirements, practitioner attributes, leadership development and service user perception are explored.In an environment where paramedics are expected to deliver innovative healthcare, partly driven by political influence it is important to understand how an extended scope of practice has involved and can be delivered while ensuring patient safety.

In helping to shape the future delivery of out-of-hospital healthcare while integrating in the changing urgent and emergency provision, paramedics must remain aware of these multifaceted drivers upon their practice.

This article reviews evidence relating to paramedics using an extended scope of practice, specifically those providing urgent care or signposting to alternative care provision setting; including paramedics with additional education (paramedic practitioners (PPs)) and those with additional training, for example using guidelines to determine patient care provider/ location.With strategic healthcare direction advocating outcome measurements to appraise the effectiveness of healthcare services, ambulance service NHS Trusts are mandated to provide effective and efficient patient care.

Developing an extended scope of practice provides benefits for the individual practitioner and patients they manage.The attributes and characteristics such paramedics’ possess are identified as desirable in robust clinical leadership provision by ambulance service personnel (CEG,2009).In a challenging healthcare setting these may provide additional flexibility and innovation for ambulance services to continue with their evolving and improving service delivery.

This article will explore political drivers for change, national experiences of paramedics with an extended scope of practice and the experience within the London Ambulance Service (LAS) NHS Trust, a busy urban service.At the time the LAS, similarly to ambulance services across England faces challenges from the response time pressures originating from call connect (Department of Health,2008), challenging their strategic provision of PPs.

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