Paramedics Transform Home Care, Reducing GP Workloads by 45%

Paramedics in Dumfries and Galloway are significantly easing the workload of general practitioners (GPs) by conducting home visits that were traditionally the responsibility of family doctors. A pilot program initiated by the Scottish Ambulance Service has resulted in a remarkable 45% reduction in GP home visits. Following the success of the trial, which began in 2018, the initiative has been expanded to include more paramedics and practices.

Under this innovative approach, paramedics receive a list of home visits each morning. They assess patients, provide necessary treatment, and then relay their findings to GPs at the end of the day. This system not only streamlines the process but also aims to enhance patient care, particularly for those who may struggle to attend a GP surgery.

Kristin Milligan, a paramedic based in Stranraer, highlights the extensive area she covers, often travelling up to 100 miles in a single day. “I can see ten people in a day,” she explains. “It’s an extra pair of hands for a GP. People are getting assessed, treated, and referred on for further care as needed.” In 2024, paramedics in this region attended nearly 400 home visits each month, demonstrating the demand for this service.

During a recent visit to a local resident, Moira, 85, Milligan conducted assessments, including checking blood oxygen levels. Moira, suffering from a chest infection, expressed gratitude for the visit. “They do all the examinations, take blood, and get things sorted with the GP for me,” she noted. Such visits are crucial for patients like Moira, who may be housebound and unable to seek help at a surgery.

Another patient, James, echoed similar sentiments. He shared his frustration at the difficulty of securing a GP appointment, stating that he was informed there were no available slots. “But they said they’d send a paramedic, so she came out and has seen to me,” he said, emphasizing his satisfaction with the service. “As long as I get seen, that’s the main thing.”

Requests for home visits are triaged by a GP. Conditions like straightforward infections are directed to paramedics, while more complex cases remain with GPs. Paramedics spend a week off their ambulance duties, focusing solely on home visits and collaborating closely with the GP practice. This arrangement allows GPs to concentrate on patients visiting the surgery, thus improving overall patient flow and care.

Dr. Charlie Dunnett, a GP in Newton Stewart, describes the transformation in workflow. “Paramedics provide all the care that’s needed, but with a GP in the background directing it and guiding it as needed,” he stated. This collaborative approach has altered the rhythm of daily operations. “Historically, the GP would do house calls at the end of morning surgery, or perhaps in the afternoon. But the busier we get, the later those visits were getting done. Now people are seen much quicker in the day, and therefore care gets started sooner.”

The pilot program has expanded to include 16 paramedics serving 19 GP practices across the region. Dr. Dunnett is optimistic about the potential for this model to be replicated in other rural areas of Scotland. “Some places perhaps paramedics would work better, perhaps other areas advanced nurses,” he suggested.

The success of this initiative has implications beyond just reducing GP workloads. Early treatment through home visits can lead to fewer unnecessary visits to emergency departments. As healthcare systems continue to adapt to growing demands, the challenge remains to successfully implement similar programs elsewhere, ensuring that more patients receive timely and effective care.