Paramedics in GP surgeries ‘do not save money’ – study

Using paramedics in GP surgeries does not save money, a new review suggests.

Paramedics have worked in GP practices for many years but their number has increased in recent years to help overstretched family doctors.

Experts from the the University of Bristol and University of the West of England camped data from 34 GP surgeries in England to assess the impact of paramedic work in a GP surgery setting.

Patients at 25 sites were seen by a paramedic and those at the remaining sites were seen by a GP.

All of those involved with the study filled out questionnaires about their experience straight after their appointment and then again a month later.

Some 489 people responded to the survey.

Responses suggested that there was no difference between patient-reported health and wellbeing whether they were seen by a GP or paramedic, according to the study which has been published in the British Journal of General Practice.

But those seen by a paramedic did report lower levels of confidence in health provision, poorer perceptions of “practice engagement in safety promotion” and appeared to have more communication problems with staff.

The authors found that patients who were seen by paramedics reported fewer GP appointments during the 30-day period after their initial appointment, but savings to the NHS were “offset by higher use of other healthcare professionals” – including a very slight increase in A&E use among those seen by paramedics.

Average NHS cost per person in the 30 days after the initial appointment were “marginally higher” among those who were seen by a paramedic compared to those who were seen by a GP.

Overall, patient cost to the NHS was £11.89 more, on average, among the group seen by a paramedic in the month after the initial appointment, the paper states.

“While PGP (paramedics in general practice) may reduce GP workload pressure, they do not necessarily reduce NHS costs,” the authors concluded.

Dr Matthew Booker, a GP and consultant senior lecturer in primary care at the University of Bristol, and one of the study’s lead authors, said: “There has been a three-fold rise in the use of healthcare professionals such as paramedics over the past five years to help tackle the significant pressure general practice services are facing owing to increased healthcare demand.

“Consultations have been rising by up to 15% annually, costing the NHS £9 billion, with a shortage of GPs to meet demand.

“Paramedics are increasingly working alongside other members of the general practice team, managing minor illnesses, conducting home visits and providing urgent consultations among other roles.

“While our study suggests that paramedics can play an important role in general practice, easing GP workload and providing clinically effective care to patients, we have found no evidence that their use is cost saving for the NHS.

“Well-designed training and supervision are needed to ensure paramedics have the right knowledge and can clearly convey healthcare plans to patients.”

Sarah Voss, professor of emergency care at the University of the West of England, added: “Our study is an important first step in understanding the impact of paramedic consultations on patient experience, safety and costs.

“Further research is needed to see whether our findings can be replicated in other primary care settings and to plan how paramedics are deployed, trained and supervised so they can quickly gain the trust of patients that they see.”

An NHS spokesperson said: “Paramedics working in GP surgeries are one option of helping people get the right care at the right time.

“We know there is more to do, and we will continue to work to help patients access treatment closer to home and so avoid unnecessary attendances at A&E.”