Ciaran takes a closer look at the current situation surrounding the UK’s Ambulance Service

By Ciaran Fletcher

Exodus in the Ambulance Service?

Okay, perhaps ‘exodus’ is a little dramatic, but there is certainly a trend at the moment where we are seeing a great many Paramedics leaving the Ambulance Services across the United Kingdom, in favour of roles within primary care, particularly GP surgeries. Why is is that Paramedics are leaving the Ambulance Service? Well, that’s what I want to explain to you in this article by highlighting some of the many differences between primary care and the Ambulance Service.

“Increase in demand for Paramedics”

Part of my role as a Specialist Recruitment Consultant for Menlo Park Recruitment is working with GP surgeries to help them recruit Paramedics and Paramedic Practitioners. When I first started in my role at Menlo Park back in September of 2019, there was genuinely very little call for Paramedic Practitioners and even less for Paramedics from the Ambulance Service.

However, more recently there has been an increase in demand for Paramedics in primary care, including those whose experience is solely on ambulances. The main reason for this is because of the Additional Role Reimbursement Scheme (ARRS) funding that has come into play within primary care in 2021. This funding is opening the doors for GP surgeries to take on additional staff to work alongside the more traditional roles within a practice, such as GPs, Practice Nurses and Health Care Assistants, thus helping to reduce the workload of staff. The advantage of this for many practices is that there is some flexibility and individuality in this role if they take on a Paramedic, based on what the surgery wants of them.

Roles of Paramedics within GP Surgeries

Paramedic roles within GP surgeries can include a great deal of variety, or be made up primarily of one task. For example, some Paramedic roles include running telephone triage clinics, seeing face-to-face appointments and even some home visits (a nice bit of variety). Other Paramedic roles are purely for home and care home rounds (a little repetitive perhaps). Naturally, there are varying levels of experience and qualifications for Paramedics but I want to focus on Paramedics from the Ambulance Service in this article, so I’ll refer specifically to them.

What Paramedics can gain from moving

When a practice takes someone on from the Ambulance Service, they can, to some degree, be treated as a blank canvass by a surgery. As long as the individual shows a desire to learn, progress and develop as a clinician, then most practices, thanks to the ARRS programme, can offer them the required support to do exactly that. This may initially be to support an individual with obtaining a particular qualification that allows them to see minor illnesses and injuries. It might be providing them with training opportunities to learn how to run telephone triage clinics. It may be having them shadow a GP or a Nurse Practitioner. Basically, in whatever way that individual Paramedic may need support, the practice can provide it.

One of the key areas that Paramedics seek support in their careers is with the obtaining of their independent prescribing qualification. This qualification opens so many doors for clinicians and effectively cements their autonomy as a practitioner, whilst also benefitting the patients of the surgery who are seen by the Paramedic too. Part of gaining this qualification includes having an in-person mentor to oversee and observe some of their work, such as a GP. It is also something that they cannot gain directly through the Ambulance Service.

Why Paramedics are looking to move on

There are many reasons as to why Paramedics are looking at leaving the Ambulance Service. To further their clinical development and progress with their careers, to gain a more structured role. The reason that I hear more than any though, is to improve their work-life balance. Shift structures on the Ambulance Service can vary massively. An example that I am using whilst writing this article is one for the Yorkshire Ambulance Service.

There are, of course, rest days integrated within this rota; but to serve as an example, an ambulance Paramedic might be expected to work twelve hour shifts from 06:00 until 18:00 for two days, followed by two days of 18:00 until 06:00 for another two days. Working such long shifts, back to back, without even the chance to get used to a week of early starts, is not good for both the mental and physical health of Paramedics. On top of this, shift patterns mean that they end up missing out on roughly seven in every ten weekends, so their social lives are affected tremendously too.

All of these factors combined (not to mention the low pay that Paramedics receive for their efforts) is what is causing large numbers of them to look at leaving the Ambulance Service (the aforementioned exodus in my title). The opportunities to progress in their careers, beyond the point where the Ambulance Service could ever take them, along with improved rates of pay and most important, in my opinion, the far better work-life balance, is almost unbelievable to some Paramedics that I have spoken with about roles within primary care.

What can Paramedics do instead?

I have worked with GP surgeries who want to make use of their ARRS funding and employ a Paramedic whom they can hone to their own requirements, support with development opportunities, including their independent prescribing and give them a real sense of what work-life balance should be! Paramedics are incredibly skilled clinicians. With the right support and training, they can develop to become Advanced Clinical Practitioners (ACPs). ACPs are immensely effective within GP surgeries. They can do home visits, work autonomously and help reduce the workload of GPs, as well as independently prescribe.

The life of a Paramedic within primary care is much better (for the most part) than with the Ambulance Service. This article is not intended to target the Ambulance Service or anything of the sort, not at all. Instead, this article is to highlight that the conditions for Paramedics in that area are seemingly a world away from the conditions within primary care.

To summarise

GP surgeries need to take advantage of the ARRS funding that is available to them and add clinicians like Paramedics to their teams, as they are wonderful, skilled, enthusiastic, hard-working people to have onboard.

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