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PP33  A service evaluation of the experiences of specialist paramedics working in rotational environments using a retrospective cohort
  1. Daniel Creton1,
  2. Mary Halter1,
  3. Clayre LaTrobe2
  1. 1Kingston University and St George’s, University of London, UK
  2. 2NHS Horsham and Mid-Sussex Clinical Commissioning Group, UK


Background The number of ambulance service-employed paramedic practitioners moving to work in primary care is increasing. Several Health Education England-supported pilot rotational programmes are underway. This study aimed to evaluate the experiences of nine paramedic practitioners in one ambulance service their first year of working on a similar local commissioner-led rotational project (segment one GP home visiting [GPHV], segment two ambulance service solo response vehicle [SRV] and emergency operations control room [EOC] whose aim was to mitigate attrition rates for both the ambulance service and primary care.

Methods We conducted a retrospective cohort study, using electronic anonymous, self-completion, mixed methods questionnaires administered seven times – pre-project, at the end of each rotation, and at the end of the first year of the rotational project. Descriptive statistics of closed questions on challenges, influence over practice, skills used, satisfaction and likelihood of leaving were conducted, and thematic analysis of the open responses conducted.

Results The survey response rate was 100% pre-project, 62.2% (n=28/45) over five rotations (n=15 after GPHV and n=13 after SRV/EOC] and 100% at end year one. Reported challenges included inappropriate utilisation of skills (33% GPHV, 55% SRV/EOC) and poor work life balance (27% GPHV), while opportunities were identified as clinical autonomy, collaboration with other healthcare professionals and clinical development (67%, 60%, 33% GPHV; 54%, 69%, 62% SRV/EOC, respectively). Satisfaction was 67% at year one, attributed to support and development from peers, GPs and immediate managers. Likelihood of leaving was reported to be decreased.

Conclusion Although small in scale, in one locality and only quantitatively descriptive this study has identified that a rotational model contributes to clinically developing and retaining PPs, and offers PPs’ views on why that is. Findings support the rotational model, though further research with a larger sample across regions and/or greater qualitative depth is required.

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