Paramedics Transform Home Care, Reducing GP Workloads by 45%

Paramedics in Dumfries and Galloway are significantly reducing the workload of family doctors by conducting home visits that would typically fall to general practitioners (GPs). A pilot program initiated by the Scottish Ambulance Service has resulted in a remarkable 45% reduction in GP home visits. Following the success of this trial, the program has been extended, showcasing its potential for broader application across rural Scotland.

Under the initiative, paramedics receive a list of home calls each morning. They visit patients throughout the day and provide recommendations for treatment to the GPs at the end of their shifts. Since the program’s inception in 2018, the number of home visits conducted by paramedics has surged, with reports indicating they now attend up to 400 home visits each month.

Kristin Milligan, a paramedic based in Stranraer, describes her daily routine. Covering a vast area, she often travels over 100 miles in a single day to see patients. “I can see ten people in a day,” she says. “It’s an extra pair of hands for a GP. People are getting assessed, treated, and referred on for further care as needed.”

During one visit, Milligan checks on Moira, an 85-year-old patient suffering from a chest infection. “They do all the examinations, take blood, and get things sorted with the GP for me,” Moira commented, highlighting the importance of the service for individuals who may have difficulty accessing traditional medical facilities.

The service is particularly beneficial for those who feel isolated at home. Milligan notes, “Some people can feel quite secluded at home. Maybe they’re housebound, so they can’t get out to see the GP.” This sentiment resonates with another patient, James, who shared his struggle to secure a GP appointment. After being told that no slots were available, he was relieved when a paramedic was dispatched to his home. “As long as I get seen, that’s the main thing,” he remarked.

Requests for home visits are triaged by a GP. Simple cases, such as infections, are directed to the paramedics, while more complex or palliative situations remain with the doctor. This arrangement allows GPs to focus on patients who visit the surgery while ensuring that those requiring home care receive timely attention.

According to Dr. Charlie Dunnett, a GP in Newton Stewart, the program has significantly altered the daily workflow for practitioners. “Paramedics provide all the care that’s needed, but with a GP in the background directing it and guiding it as needed,” he explained. Traditionally, GPs would conduct home visits after their morning surgeries, often leading to delays in patient care. With paramedics handling these visits, patients receive quicker assessments and treatments, which can expedite necessary hospital admissions.

Dr. Dunnett’s practice extends over a wide area, making home visits a logistical challenge. “The busier we get, the later those visits were getting done,” he said. “Now people are seen much quicker in the day, and therefore care gets started sooner.” He expressed optimism about the program’s potential for replication in other rural areas of Scotland, suggesting that while paramedics may be the best fit for some regions, advanced nurses could be more effective in others.

This innovative approach not only addresses the immediate need for home care but also reduces unnecessary visits to Accident and Emergency services. The success of the Dumfries and Galloway pilot demonstrates the effectiveness of integrating paramedics into primary care settings, paving the way for a more responsive healthcare system in rural communities. As health services evolve, the challenge will be to maintain the program’s success while exploring similar initiatives in different regions.