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Pioneering paramedics schemes go live

PUBLISHED: 10:14 30 November 2001 | UPDATED: 10:56 03 March 2010

A GROUND-BREAKING scheme to base paramedics in doctors' surgeries in rural towns and villages, is being introduced across Suffolk, Norfolk and Cambridgeshire.

A GROUND-BREAKING scheme to base paramedics in doctors' surgeries in rural towns and villages, is being introduced across Suffolk, Norfolk and Cambridgeshire.

The first batch of more than 20 schemes has the dual aim of improving ambulance response times and creating greater links with primary health care.

The paramedics, equipped with a fast response car and the usual emergency medical kit, will answer 999 calls and also play a role in the surgery and in educating the local community in basic life-support skills.

There are now paramedics based in Stowmarket at a surgery still to be announced, Saxmundham's surgery in Lambsale Meadow, and in Sudbury at a surgery to be announced.

Hadleigh will have a paramedic in a doctors' surgery in the next three months.

The East Anglian Ambulance Trust, the most rural ambulance service in England, is the first in the country to formally introduce such a scheme.

Dr Chris Carney, chief executive of the trust, said it was essential to find a solution to the problems of providing rapid emergency care in rural areas and of meeting the government's new response time target of reaching 75 per cent of life-threatening calls within eight minutes.

"To achieve these new response time targets, we have had to radically change the way we work. We could almost certainly achieve the targets by simply flooding urban areas like Norwich, Ipswich, Peterborough and Cambridge with extra resources," he added.

"But while on the surface we would be successful, there would be an increased urban/rural divide. We needed to find a solution to afford a level of equity in rural areas.

"The rurality of the Trust does not lend itself to cost effective solutions based on investing in large numbers of paramedic ambulances sited in all rural areas.

"These vehicles would perhaps attend one or two calls a day and, on doing so, deny the area of cover for two hours at a time when the patients are transported to the nearest hospital. These units cost more than £300,000 a year to run and health authorities could not afford to invest on the scale required."

He said all clinical evidence says quick attendance with basic life support and defibrillation is the key to survival for most life-threatening calls.

"This can be best provided by a community based paramedic with full equipment and a response car, based in more rural town and village locations, covering a specific geographical area or 'beat'," added Dr Carney.

Because of the lower number of emergency calls in rural areas, the paramedics will inevitably have some hours of daily spare time where they can help in the surgery, assisting with blood tests, and can be helping doctors assess urgent calls received during surgery.

In return, surgery partners and practice nurses can help the paramedic with patient assessment skills and involve them with chronic disease management clinics – in asthma and diabetes in particular.

The paramedics are on duty for 40 hours per week, usually Monday to Friday.

They will arrange to involve other emergency services, as well as NHS staff and voluntary aid societies' personnel for when they are off-duty.

Dr Carney added: "Their primary role will naturally be to respond to 999 calls, and that is the criteria on which the schemes will ultimately be judged. But the benefits will be improved local emergency care for patients, better community capability for coping with emergencies and an additional skilled pair of hands funded by the ambulance service.

"We see this as an exciting new development and an initial step towards collaboration with primary health teams to improve patient care – particularly in rural locations."

Shirley Saunders, ambulance services commissioner for the three health authorities, said: "The rural nature of East Anglia needs a different approach from the traditional ambulance service, and this is an innovative and effective new approach.

"We hope that the local communities will see this as a positive step forward and reap the benefits of improved response times."

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