Advanced paramedic practitioners
Topic Status Complete
Advanced paramedic practitioners for assessment and treatment of medical emergencies
Outcome of the appraisal
The use of advanced paramedic practitioners in pre-hospital emergency care shows promise, but there is currently insufficient evidence to support routine adoption.
There is limited comparative evidence available against standard care and the wide range of roles and competencies of pre-hospital practitioners included in the published studies limits the certainty of this evidence. A full assessment of cost effectiveness is not possible on the basis of the currently available evidence.
HTW recommends further research, using system-orientated approaches to the analysis of data currently available in Wales, and incorporating patient and organisational outcomes into future comparative studies. Further research to address costs and cost effectiveness associated with the use of advanced paramedic practitioners in emergency care is also recommended.
Why was this topic appraised?
At times of high demand, ambulances are often delayed in delivering patients into busy hospital emergency departments. Some people who contact emergency services can receive the care they need in community settings. Advanced paramedic practitioners are paramedics with extended, post-graduate training that allows them to make more independent clinical decisions in the community than paramedics with standard competencies. They can also carry extra equipment and medicines to care for patients. It has been suggested that the use of advanced paramedic practitioners in Wales may reduce the number of people taken to hospital and increase the number who are able to safely receive appropriate care in the community.
This topic was suggested by Welsh Ambulance Services NHS Trust (WAST).
Plain language summary
People who need emergency care can call for the help of the ambulance service. Ambulance staff, called paramedics, provide specialist care to patients who have been involved in accidents, emergencies or other crises. This can include conducting assessments, administering life-saving care and making decisions. Care usually, but not always, ends in the person being brought to hospital for further treatment.
Advanced paramedics practitioners are paramedics who have extra training. They are able to carry extra equipment, attend more complex incidents and may be able to make more effective decisions, such as referring someone to primary care. This may help reduce the number of people who need to be taken to hospital and free up more ambulances for other calls.
Topic Exploration Report
TER481 11.2023
Evidence Appraisal Review
EAR059 07.2024
Guidance
GUI059 07.2024
Health Technology Wales Partners
