Caroline French

Primary Care GP Practice 

Job Title: 
Advanced Paramedic Practitioner
Place of Work: 
Co. Tyrone. Northern Ireland

What does your job include?
My role as an advanced paramedic practitioner in primary care commences daily with post Covid telephone triage consultation from 9am each morning to assess need for advice, medication or further assessment and investigations. As a generalist these triage calls account for any presentation and age group.  15 minute consultation slots are filled from this triage system. Triage is morning and afternoon. Home visit requirements are also filtered through and are shared equally between appropriate clinicians. There is some flexibility in my practice for acute walk in presentations. Assessments include advance examination depending on presentation, blood tests, cultures, access to local pathways including cardiac assessment unit, same day x-ray referrals and referral to all disciplines.  N Ireland legislation has only recently changed to allow Paramedics to prescribe and this allows autonomy in practice. Access to ECR,  Docman and lab results are instrumental to complete patient assessment and treatment. NICE guidelines and local policies for antibiotic prescribing are instrumental for safe practice. Governance is provided by Dr for open door consultation with regular auditing of practice. The MDT includes a highly skilled team which includes a physio, mental health practitioner, social worker and pharmacists.  

We have also have multi skilled nursing team and access to great district nursing team. Collaboration is so important for good patient care. This is also a teaching practice which has weekly medical students for observation and detailed discussion. I had considered eventually specialising in specific area like women's sexual health however on discussion with GP partners, they feel the real value of paramedics in practice is the generalist practice we offer. The demand in primary care at present is unprecedented and provides a very challenging environment.

How did you get into your role?

My career commenced in 1999 in NIAS and I became a HCPC registered in June 2009. I was one of two Paramedics involved in the first pilot Community Paramedic project rolled out in Northern Ireland in Sept 2017. It was a collaboration between N Ireland Ambulance Service and primary care, minor injury units and the local emergency departments coupled with an opportunity to study for MSc in advanced paramedic practice. Funded by Interreg and implemented by C.A.W.T, European funds were distributed in rural areas of socio and economic deprivation and long transfer times to hospital.  During this time I was honoured to be awarded the inaugural NIAS Paramedic of the Year 2019. This scheme ran well until completion in June 2020 and at this stage Covid was impacting service delivery so we were back to helping out on frontline. I left the ambulance service in June 2020 and commenced working in local OOHRs as advanced paramedic practitioner. I had completed my MSc at this stage.  I completed my PgD in medicines management in June 2021 with legislation updated in March 2022 to allow paramedics to prescribe in primary care in N Ireland.  An opportunity arose in Jan 2022 to return to primary care in the area I had been working in pre hospital care for almost 20 years. It is early days with lots to learn but the challenge continues…

What do you think is the most important benefit of being a member of the College of Paramedics, and why?
The most important benefit for me is connection.  Connection with colleagues both locally but also nationally and internationally. As healthcare professionals, we are pushing the boundaries together to maximise CPD, training, opportunities and by doing so, creating space and opportunities to grow and learn. Recent attention to mental health, equal opportunities for women and empowering students are crucial. As a nation, N Ireland sometimes can feel isolated and the recent CoP workshops provided us with an opportunity to hear first hand the plans the college have going forward and gave us an opportunity to engage.  As the space for Paramedics continues to grow, we must recognise we are stronger as a group moving forward.