PRIMARY AND URGENT CARE

This is where I will collate and share resources, links and top tips for our members.  If you have other information you feel would be useful to share with your peers, then do contact me at primarycare@collegeofparamedics.co.uk and I can arrange for this to be added.  

I will endeavour to post updates every couple of weeks and also let you know if there are any workstreams or opportunities that members can become involved in.  This page is your page, so do get in touch if there is something you want to see.   

- Helen Beaumont-Waters MCPara
 


To view all resources, join the College of Paramedics as a member and follow the link below.

Community of Practice for Primary Care Paramedics

We are very excited to announce the College of Paramedics has created a Community of Practice for Primary Care Paramedics with funding support for the set-up from NHS England. It will be a peer-led discussion group to provide support, guidance and learning opportunities primarily for staff who now work in a primary care environment. We know the change of work environment can be a complex transition, with many paramedics being the only one in a surgery, so we want to create a safe space to help smooth out your journey. It will provide an opportunity to ask questions, discuss clinical cases and support one another, think of it like an online crew room.

The Community will be mostly based in the College of Paramedics Community on the Fourteen Fish e-portfolio, which all primary care paramedics can currently access for free. A wide selection of information will be made available to help support all levels of primary care clinician, so they have the knowledge to perform their new clinical role safely and effectively. The pressures faced in primary care can differ vastly from those seen on an ambulance and therefore we want to help all our colleagues to look after themselves as well.
 
The main focus of the Community of Practice will be around a series of case-based discussions. We will be discussing a range of primary care clinical cases to demonstrate the variety of assessment and treatment options available in primary care. As we dissect the cases through an interactive discussion, we hope to enhance your problem-solving skills and deepen your medical knowledge for a variety of relevant case presentations. At the end of the month, we plan to host a virtual discussion, available for all College of Paramedics members, to offer a valuable insight into the diagnostics, interventions and patient outcomes seen by paramedics in the world of primary care. 

29th February 2024

5th February 2024

Please note NICE have updated the Sepsis guidelines, link below. 

Overview | Suspected sepsis: recognition, diagnosis and early management | Guidance | NICE 

3rd January 2024

Controlled Drugs; Legislation Changes Webinar
 
Andy Collen, Consultant Paramedic at SECAmb who on behalf of the College led the Medicines and Prescribing Projects chaired this panel of College of Paramedics experts, David Rovardi, Pharmacist, Independent Prescriber and Registered Paramedic and Specialist Medicines Advisor, College of Paramedics, Helen Beaumont-Waters, Head of Clinical Development (Primary and Urgent Care) College of Paramedics and Carl Smith, Head of Clinical Development Emergency and Critical Care, College of Paramedics, as they discussed Controlled Drugs; Legislation Changes.

This webinar was facilitated to provide information to our members following the recent announcement regarding regulatory changes to the Misuse of Drugs Regulations 2001 to allow paramedic independent prescribers to prescribe and administer, and direct others to administer, the following five controlled drugs:
• Morphine sulfate
• Diazepam
• Midazolam 
• Lorazepam and 
• Codeine phosphate

Topics of discussion were:
• The medicines selected
• Safe, responsible and legal use of these medicines
• Deprescribing
• Relevant guidelines and good practice
• Practical points
• The future

To watch the webinar please click the link below...
Controlled Drugs; Legislation Changes

Controlled Drugs; Legislation Changes Slides PDF

21st July 2023

As members are aware, last year a group of senior paramedic leaders and member representatives worked on a strategy response to paramedics not being included in the Fit Note policy changes.  Along with data which was collected from members, a policy brief was sent to the Department of Work and Pensions (DWP) which members can read here.  

The DWP have now gone to consultation on their Occupational Health: Working Better publication which paramedics can view here. We are urging paramedics to share this widely as one of the questions asks if other professionals should be considered in scope to complete issue Fit Notes (question 21). This consultation closes on 12th October.  Please note that to respond as an employer, healthcare professional or non-healthcare professional you will need to scroll to the bottom of the page, download and complete the word document and then email it to oh.consultation@DWP.GOV.UK

Download and complete the word document here.

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3rd February 2023

Last week all the professional bodies with a Roadmap met in London with the team from the Centre of Advancing Practice. The aim was to discuss any recurrent problems FCPs were facing, and determine as part of a quality review, what might need changing, removing, adding or simplifying.  This work continues and we want to assure all our members that we absolutely have a voice at this table and welcome any additional comments to feed into this work.  Contact us at primarycare@collegeofparamedics.co.uk with any suggestions and feedback.

Much of January has been spent ensuring that the e-portfolio to support paramedics in primary care is the best it can be and that it will help those working on their First Contact Practitioner capabilities.  The e-portfolio project is being led by Ben Baker who is our Workforce Reform Officer in the Clinical Development directorate, and he has been working tirelessly to ensure this will be a useful tool for all paramedics working in primary care roles in all nations.

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Dear Colleagues,

The College of Paramedics is delighted to announce that we have developed a paramedic specific e-portfolio for you to use as an individually focused resource. After a number of our focus groups identified the need for such an opportunity and following a review of the available e-portfolio possibilities, we choose to collaborate with Fourteen Fish. The portfolio enables you to collate all your post-graduate learning conveniently into one single database, which you can use to assist in demonstrating your progression along your chosen career pathway.

Initially it has been designed as a stepped approach for primary care paramedics including the clinical competencies required for the first contact practitioner (FCP) roadmap and the additional requirements for advanced practitioners or consultant level practice. As Fourteen Fish is the e-portfolio that most GPs use, this subsequently makes the supervisory requirements of the FCP roadmap and ACP pathways easy to navigate for supervising GPs, which was also confirmed during the pilot/test phase. The format of the portfolio allows all paramedics working towards these goals to map their own individual journey, whether via a formal or a portfolio route, to achieve the same goal. 

The portfolio rolls over each year so you can continue to evidence your learning and demonstrate how you are continually upholding your job specific clinical competencies. You can also change your job title and the portfolio updates your recommended achievable goals as identified for the next stage of your chosen pathway. The e-portfolio also helps you to identify areas that you may not have done enough learning, so provides ideas for your future development.

The next phase of the e-portfolio is the addition of the common capabilities for paramedics working in other non-traditional clinical environments, firstly for paramedics working in urgent care settings such as walk in centres or out of hours. We also have plans in place to add the capabilities for other clinical areas, particularly where frameworks already exist.  Our aspiration is that paramedics can map their entire career trajectory after completion of newly qualified paramedic all the way to consultant practitioner, or wherever else your path may take you, on this simple to use and paramedic specific e-portfolio.  

Members of the College will need to create a ‘Fourteen Fish’ account to access the e-portfolio Join: College of Paramedics - FourteenFish

I hope you find it useful, do get in touch with me at ben.baker@collegeofparamedics.co.uk if you have any questions,

Ben Baker, Workforce Reform Support Officer

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4th January 2023

Following a member query regarding paramedics requesting imaging, the following statement has been received by the Professional Officer for Clinical Imaging and Radiation Protection at the Society of Radiographers.

This helps clarify why some radiography departments work differently to others.  Please ensure you work within your local guidelines and pathways.

“As registered healthcare professionals, paramedics may be entitled to act as referrers under the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2017. 
 
We are aware of the immense contribution non-medical referrers make to effective and efficient patient care pathways. However, we also see the growth in work and oversight required for those departments, to have in place robust processes, to ensure compliance with IR(ME)R. IR(ME)R does not specify a particular training requirement for referrers, but the IR(ME)R regulators will expect to see a procedure in place for the entitlement of non-medical referrers and this is likely to reflect training and education, registration standards and professional body guidance. The ‘IR(ME)R’ training you refer to is likely to be a basic requirement for awareness of radiation protection, doses, and referral guidelines etc. In and of itself it does not confer entitlement. 
 
Entitlement is granted by the IR(ME)R employer to whom an individual is referring, so it may differ between employers as you have noted. The employer will need to be satisfied that the referrer is working within their scope of practice. They should also consider how this impacts service improvement measures. Although IR(ME)R does not distinguish between medical and non-medical referrers, in practice, each entitlement for non-medical referrers reflects a clearly defined (and usually limited) scope of practice. It is the employer’s decision whether to entitle someone as a duty holder under IR(ME)R.
 
One other point which is often overlooked is that if a non-medical referrer is also expecting to make a clinical evaluation of the images (rather than wait for the radiology report) then they must also be trained and entitled as an IR(ME)R operator to do this. This training is detailed in schedule 3 of IR(ME)R and would need to be evidenced relative to the individual’s scope of practice. Making the referral and making the clinical evaluation are two different duties under IR(ME)R and require quite different training, education, and practical experience.
 
This professional body guidance was written by SoR and RCN and is applicable to all non-medical referrers. https://www.rcn.org.uk/professional-development/publications/rcn-clinical-imaging-requests-uk-pub-009-108

The joint professional body guidance IR(ME)R: Implications for clinical practice in diagnostic imaging, interventional radiology and diagnostic nuclear medicine may also be of interest.”

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22nd December 2022

Following a recent member enquiry requesting clarification regarding passport signatories, we have received the following narrative via the DHSC to confirm paramedics are indeed recognised as a profession allowed to countersign passports.  The list on the government website is a list of example professions, please be assured that if you are requested to countersign a passport you are allowed to do so.

“The countersignatory, or referee, must be someone in (or retired from) a recognised profession, who has credentials that can be checked. This means they would have something to lose, albeit professionally or through loss of reputation, by supporting an application which is not genuine.

To assist the public, a list of recognised professions can be found on Gov.UK: Confirm someone’s identity online for a passport application: Who can confirm someone’s identity - GOV.UK (www.gov.uk)

It should be noted that this is a list of examples. It is not a definitive list, and any alternatives a customer provides must be considered. Clearly, paramedics perform an important and responsible role in society, comparable with many of the professions in the current list. Officials have been reviewing the referee requirements and will ensure the views of the College of Paramedics are taken into account as part of this work.” (December, 2022). 

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Primary and Urgent Care

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