3 research outputs found
Advanced paramedics in general practice in Ireland – an exploratory study
Get PDFIntroduction: Healthcare policy in Ireland is in a state of transition due to an increased aging
population with chronic disease and co-morbidities, demands for services will rise. To help
reduce pressures on the acute hospital setting, more patients and services are being directed
towards general practice and primary care services. As Irelands population increases and
chronic disease becomes more prevalent, demand on limited general practice services will
increase. Current and future predictions suggest that there are insufficient numbers of existing
General Practitioners (GPs) available to meet this increased demand. Globally, during times
of healthcare workforce shortages, various health systems have adopted “task shifting”
models of healthcare delivery, where certain roles or tasks are undertaken by alternative nonmedical personnel with less education and training, in order to alleviate some of the pressures
on limited medical personnel. Evidence suggests that there is an appetite among GPs for
change within other jurisdictions. Nursing roles within general practice are now considered to
be standard, yet alternative non-medical professional roles have not been explored within an
Irish context. Non-medical personnel such as Advanced Paramedics (APs) may have the
capability to provide support to general practice. APs are an untapped resource that may not
always be utilized to their true potential. Integrating APs into general practice may provide
much needed support to general practice that may be mutually beneficial for both parties and
their patients alike.
Aim: The aim of this study will be to explore GPs attitudes and opinions of integrating
Advanced Paramedics into rural general practice in Ireland.
Methods: A sequential explanatory strategy design was adopted, utilising a mixed
quantitative/qualitative methodology. The first phase of the study (quantitative research)
employed a quantitative questionnaire designed and distributed to a purposeful sample of GPs
attending a rural conference. The interview guide for the second phase of the study
(qualitative research), was informed by the first phase (quantitative research). Thirteen GPs
were recruited and participated in an online semi-structured interview. Interviews were
recorded and transcribed verbatim and analysed utilising thematic analysis.
Results: Twenty-seven GPs responded to the survey. Response demographics replicate
previous studies on rural general practice with many participants over sixty years of age.
Majority of GPs were familiar with AP practice. Most GPs favoured APs performing patient
assessment and management of a variety of clinical procedures on their behalf in the
community and within their surgery. Data was scrutinized through thematic analysis and
categorised into subthemes and three main themes emerged: GPs described the future
healthcare challenges facing general practice, primary care and paramedicine partnership and
theory to tangibility where potential opportunities for collaboration and support could be
exploited
Conclusions: This study replicates published research on the challenges facing general
practice in Ireland. GPs are facing a crisis especially within rural general practice. Despite
these challenges, GPs remain optimistic and understand that current models are unsustainable
and will require change to sustain future services. GPs are innovative in their thinking and
recognise the potential of integrating APs into general practice and collaborating in areas of
out-of-hours services, home visits, nursing homes and even roles within the general practice
surgery. GPs believe a future partnership with APs would have to be team based and built
upon mutual trust. Though GPs and APs dovetail in many facets of mutual patient care, APs
will have to learn to adapt their approach to general practice for this new partnership to
succeed
