UK unveils "super paramedic"

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http://www.ems1.com/trauma/articles/772225-UK-unveils-new-breed-of-super-paramedics/

UK unveils new breed of 'super paramedics'
By Sara Thomas
Daily Post

WREXHAM, Wales — A new breed of 'super' paramedics — the first of their kind in the UK — are taking to the roads of North Wales.

The Welsh Ambulance Service is setting up a network of highly-skilled and equipped specialist practitioners across the region ready not just to respond to emergencies but also to make decisions about aftercare.

They will undergo specialised training to graduate and postgraduate level to equip them for their new role.

Read more
 
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Interesting... I was wondering when something like this would happen somewhere...
 
It can happen here if we can ever manage to move Paramedicine into the realm of college degrees. But it does mean that Paramedics need to become experts in more than the very narrow area they specialize in now and need to become more generalists - at least in the still specific area of acute emergency care.
 
The UK paramedics use to have less training than ours even into the mid 90's from what I understand. There degree requirement and extended training is not very old.

Anyway you look at it though, they got a jump on us now for sure
 
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For a country with socialized medicine, they are blazing the trail as to how things ought to be done.

I applaud them. And I am heavily in favor of socialized medicine if this is the sort of advancement and excellent patient care it delivers.
 
I'm interested in the changes are in scope of practice, but more importantly, what aftercare options are made. What differs this rank from that of "Paramedic Team Leader", ie Mark Glencourse (Medic99.fireemsblogs.com)?
 
The article was a bit vague about terminology but I think what they were getting at was the extended care practitioner program which is not terribly new. It does seem to be a standard media ploy in health matters to "unveil" these programs after they have been running for a while though.

The extended care model is of great interest to me. In two states here (Queensland and South Australia), the model has been trialled and found to be quite successful. Here in Victoria there has been a little talk of it but it is certainly in its infancy.

There is a lot of talk about the best role for these paramedics. Here the program has involved literally taking the simple commonly used parts of the ED to the pt (which strikes me as being somewhat inefficient) for quite serious cases. Suturing, and an i-Stat machine for blood chemistry and troponin are the biggest additions to standard ALS practice in terms of "skills" that I know of. The more important component here though is the education and experience to be able to meaningfully apply these skills.

The UK models, however, tend to focus on the encouraging out of hospital management of less severe issues such as asthma cases that would previously be admitted. This means spending more time on the "dunny jobs" as many would put it, and I can't see it being that popular with paramedics. It may end up being (or being perceived to be) not overly dissimilar to watered down GP practice - something few paramedics, especially the bright ones who extend themselves with the kinds of post grad education that this requires, want to do.

I'm writing an essay about future models of extended care for one of my subjects this semester... so lets get a good conversation going :P
 
Contrary to what the article says, these types of paramedics are not the first of their kind in the UK (perhaps in Wales though). They are ECPs with another name, and ECPs have been around for about 7 years.

The idea is to have a clinician with more extended training and education, who can handle the lesser (for want of a better word) jobs, which do not need to be treated in a hospital. As well as being able to treat-and-release at their own discretion, they can also order follow up tests to be done in primary care facilities other than the ER - including x-rays etc (without the need to "ask" a Doctor).

Treatments such as dressing changes, suturing, Foley cath changes, neb treatments, and prescriptions for URIs / UTIs etc (yes they have limited Rx rights like NPs) can all be handled in the home. This is the bread and butter of the ECP.

For something like this to work, it needs a change in the mindset of both the public and the ambulance service. People who call 911 / 999 are calling for medical attention, not necessarily for a ride to a hospital. The ECP can usually take care of those non-critical patients, who would normally be sat in fast track in the ED, thus freeing up its resources for the more acute / critical cases.

A very specialized role but I agree it is not a job for a lot of paramedics, due to the isolation of the role, and less acute patient load.

Wiki ECP
http://en.wikipedia.org/wiki/Emergency_Care_Practitioner

An old report from 2004
http://www.dh.gov.uk/prod_consum_dh...@dh/@en/documents/digitalasset/dh_4093088.pdf

Oh, and an old BBC report from half a decade ago...knew I had read about "Super Paramedics" before. http://news.bbc.co.uk/2/hi/health/4634569.stm
 
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emt.dan said:
What differs this rank from that of "Paramedic Team Leader", ie Mark Glencourse (Medic99.fireemsblogs.com)?
Click to expand...

An ECP isn't a rank, it is a clinical speciality. A team leader is a leader of a team - of paramedics (and techs), involved in administrative stuff such as the running of a shift. This on top of the usual role required of a paramedic.

Think Dwight Schrute more than Clark Kent ^_^
 
Scott33 said:
Contrary to what the article says, these types of paramedics are not the first of their kind in the UK (perhaps in Wales though). They are ECPs with another name, and ECPs have been around for about 7 years.

The idea is to have a clinician with more extended training and education, who can handle the lesser (for want of a better word) jobs, which do not need to be treated in a hospital. As well as being able to treat-and-release at their own discretion, they can also order follow up tests to be done in primary care facilities other than the ER - including x-rays etc (without the need to "ask" a Doctor).

Treatments such as dressing changes, suturing, Foley cath changes, neb treatments, and prescriptions for URIs / UTIs etc (yes they have limited Rx rights like NPs) can all be handled in the home. This is the bread and butter of the ECP.

For something like this to work, it needs a change in the mindset of both the public and the ambulance service. People who call 911 / 999 are calling for medical attention, not necessarily for a ride to a hospital. The ECP can usually take care of those non-critical patients, who would normally be sat in fast track in the ED, thus freeing up its resources for the more acute / critical cases.

A very specialized role but I agree it is not a job for a lot of paramedics, due to the isolation of the role, and less acute patient load.

Wiki ECP
http://en.wikipedia.org/wiki/Emergency_Care_Practitioner

An old report from 2004
http://www.dh.gov.uk/prod_consum_dh...@dh/@en/documents/digitalasset/dh_4093088.pdf

Oh, and an old BBC report from half a decade ago...knew I had read about "Super Paramedics" before. http://news.bbc.co.uk/2/hi/health/4634569.stm
Click to expand...

Indeed. Very nice post. Do you think you would have trouble getting paramedics to spend they days dealing specifically with low acuity cases when the culture in EMS tends to value cases by how sick a person is?

I can see there being medics suited to these roles. I think many paramedics here want to extend themselves clinically but don't necessarily want the stress of working on an MICA truck. So I can see there being people signing up for these masters degrees, but I wonder how many.

The South Australian ECP program that I mentioned appears to be focused less on low acuity pt and more on a mobile ED, although I haven't anything more than a few short reports to base that on.

There is a report called "An exploration of expanded paramedic healthcare
roles for Queensland" that briefly discusses most of the models around the world. I can't for life of me think where I got it. If anyone is interested I can email it to them but I can't seem to find it on the web for free anymore.
 
bstone said:
For a country with socialized medicine, they are blazing the trail as to how things ought to be done.

I applaud them. And I am heavily in favor of socialized medicine if this is the sort of advancement and excellent patient care it delivers.
Click to expand...
Yep. Another country with socialized medicine, USSR, used to have a PHPA, an emergency physician (with a relevant specialty - there were cardiac MICUs, pediatric MICUs, toxicological MICUs, etc), and a professional driver with EMT-like training on every ambulance (Russia still has physicians and professional drivers on most trucks, even though under capitalism it's severely underfunded and slowly falls apart; it's not uncommon to see trucks with only a driver and a PHPA, and they are currently discussing getting rid of the drivers and making PHPAs drive trucks instead, like paramedics in the US).
 
Interesting topic. Interesting approach by the UK. Of course in America, under our current for profit system, paramedics will never be elevated to the level outlined in the UK article and subsequent posts have indicated. Ambulance transportation is the only way ambulance services make money and therefore survive. Even the not-for profit services like fire departments rely on revenues generated by transporting the patient. This model encourages quick, fast, efficient transportation, so the ambulance is freed up to run another quick, fast efficient transport. Our model here in the US would require a significant change that was not tied to ambulance transport re-imbursement. In many ways this system does encourage quick definitive care as the patient ultimately does see a doctor. Although I do see advantages to a "super-paramedic" that sounds like a physician assistant by the type of treatment modalities that were described in some of the earlier posts. Any paramedic that has worked any length of time would agree that not having to transport some of the less emergent patients would be an efficient use of ambulance resources.
 
I remember in the chatroom once, Ridryder911 talking to us about something along the same lines (or close to it),
that they were looking at doing in the States.
Guess the Brit's beat you to it.

Enjoynz
 
enjoynz said:
I remember in the chatroom once, Ridryder911 talking to us about something along the same lines (or close to it),
that they were looking at doing in the States.
Guess the Brit's beat you to it.

Enjoynz
Click to expand...
Nope. Will never happen here in the states. Our greedy little system of capitalism would never allow true health care to prevail
 
NWParamedic said:
Nope. Will never happen here in the states. Our greedy little system of capitalism would never allow true health care to prevail
Click to expand...

I agree it will never happen. As has been mentioned before in other threads, the US system would need to be completely rebuilt from scratch for something like that to work.
 
I love how certain people here use this as a "kudos" on socialized health care. Socialized health care will RUIN our healthcare system in the US. If you don't believe that, go to canada, where after having a heart attack, you must be put on a waiting list to get your "emergency" angioplasty and stent placement.

Oh.. and on top of that.. you think we make low salaries now? Wait til the government takes 40% of your paycheck instead of the 15-25% they take now and gives you a lower quality of healthcare.

Besides, how long do you think it will be before the federal government "mandates" the salaries of healthcare providers in order to "control costs"?

55% of americans are opposed to universal health care/obamacare/socialized medicine.. which ever term you prefer.

There is a reason for this!

Oh, and there will come a time when states begin to implement an advanced practice paramedic program like this. It will take time, and it wont be appropriate in every locality in the US either. By keeping the attitude that it would never work, and it wont ever be allowed to happen here.. is whats keeping it from happening here.
 
It sounds like this could available anywhere to anyone with PA who does house calls
 
FLEMTP said:
I love how certain people here use this as a "kudos" on socialized health care. Socialized health care will RUIN our healthcare system in the US. If you don't believe that, go to canada, where after having a heart attack, you must be put on a waiting list to get your "emergency" angioplasty and stent placement.

Oh.. and on top of that.. you think we make low salaries now? Wait til the government takes 40% of your paycheck instead of the 15-25% they take now and gives you a lower quality of healthcare.

Besides, how long do you think it will be before the federal government "mandates" the salaries of healthcare providers in order to "control costs"?

55% of americans are opposed to universal health care/obamacare/socialized medicine.. which ever term you prefer.

There is a reason for this!

Oh, and there will come a time when states begin to implement an advanced practice paramedic program like this. It will take time, and it wont be appropriate in every locality in the US either. By keeping the attitude that it would never work, and it wont ever be allowed to happen here.. is whats keeping it from happening here.
Click to expand...
FLEMTP,

Thank you for your counter argument. The only problem with it is you are simply re-stating the old republican playbook.

First of all canadians are very happy with their healthcare system. This standard statement of pointing to the canadian system as an example of how bad "socialized medicine" is bogus. See the article below:

http://new-canadian.blogspot.com/2009/07/shocking-poll-canadians-happy-with.html

Secondly, you indicate that salaries will be reduced. This is pure speculation on your part. You have no idea what will happen with salaries. You are simply stating your opinion as a fear tactic. Lets again look at some factual information. Here are what paramedics are making in the UK.

http://www.prospects.ac.uk/p/types_of_job/paramedic_salary.jsp

Roughly they are making 30-50 thousand per year with better benefits than us. So certainly not 40% less than what we are making now.

Your third ascertion is that 55% oppose Obamacare. This statistic may actually be correct. Because if you listen to either side of the argument through the media you are inclined to just vote party lines. Which the country is politically split right down the middle right now. Secondly, many who originally were in favor of the early proposals were for the bill and after changes have decided to now oppose it. Unfortunately the bill has been so compromised many have just decided to vote against it.

And finally you believe that the advanced practice paramedic will still evolve in our system of healthcare. Well I have to tell you. When I first became a paramedic back in 1990, we would frequently talk about this subject and we would often point to the future when PA's would be riding the ambulances so that we could make emergency ambulance efficient so we could run real emergencies. Well that day is still coming. Again this day will never come in our current system of transport re-imbursement.
 
NWParamedic said:
FLEMTP,

Thank you for your counter argument. The only problem with it is you are simply re-stating the old republican playbook.

First of all canadians are very happy with their healthcare system. This standard statement of pointing to the canadian system as an example of how bad "socialized medicine" is bogus. See the article below:

http://new-canadian.blogspot.com/2009/07/shocking-poll-canadians-happy-with.html

Secondly, you indicate that salaries will be reduced. This is pure speculation on your part. You have no idea what will happen with salaries. You are simply stating your opinion as a fear tactic. Lets again look at some factual information. Here are what paramedics are making in the UK.

http://www.prospects.ac.uk/p/types_of_job/paramedic_salary.jsp

Roughly they are making 30-50 thousand per year with better benefits than us. So certainly not 40% less than what we are making now.

Your third ascertion is that 55% oppose Obamacare. This statistic may actually be correct. Because if you listen to either side of the argument through the media you are inclined to just vote party lines. Which the country is politically split right down the middle right now. Secondly, many who originally were in favor of the early proposals were for the bill and after changes have decided to now oppose it. Unfortunately the bill has been so compromised many have just decided to vote against it.

And finally you believe that the advanced practice paramedic will still evolve in our system of healthcare. Well I have to tell you. When I first became a paramedic back in 1990, we would frequently talk about this subject and we would often point to the future when PA's would be riding the ambulances so that we could make emergency ambulance efficient so we could run real emergencies. Well that day is still coming. Again this day will never come in our current system of transport re-imbursement.
Click to expand...

^_^
And that, friends, was extremely well said.
 
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