First contact paramedics are autonomous, diagnostic clinicians with experience in handling undifferentiated and unpredictable cases; conducting an array of clinical assessment, diagnostic, and treatment activities; and directing and signposting care. They are at the top of their clinical scope of practice at Agenda for Change Band 7 (A Roadmap to Practice, see below).

As generalists, they can effectively use the medical / biopsychosocial model to assess, examine, treat, and manage patients of all ages, with a variety of undifferentiated and chronic conditions. Their work can involve triaging patients, carrying out telephone and face-to-face consultations, and conducting home visits. They refer patients to GPs for the management of presentations and pharmacology outside their scope of practice.

For more information, please read HEE’s A Roadmap to Practice and the College of Paramedics’ Employers’ Guide: Paramedics in Primary and Urgent Care.

GPs face a constant and increasing demand for their time. First contact paramedics can help to alleviate this by addressing a wide range of undifferentiated presentations to urgent and primary care (including frailty, long-term conditions, and mental health crises). In so doing, they not only enable GPs to turn their attention to more complicated presentations when needed, but paramedics also ensure that patients can receive equitable treatment from a MDT workforce that isn’t so unduly strained. Patients are less likely to need to go to the hospital, as paramedics are well-equipped to see, treat, and / or refer as appropriate by themselves performing home visits.

Please see the Paramedic Specialist Core Capabilities Framework below for more information.

“Paramedics have so many complementary skills and in primary care there are many areas where paramedics can complement the rest of the primary care team, not least acute care, but also, domiciliary visiting and follow up to the same that may well enable patients to stay in their own home rather than be admitted to hospital…“

Professor Simon Gregory
Director of Education and Quality
(HEE, working across Midlands and East)

(Ref. Paramedic Specialist Core Capabilities Framework)

First contact paramedics’ scope of practice is outlined in HEE’s A Roadmap to Practice for first contact and advanced paramedics. This document offers a clear educational pathway from undergraduate to advanced practice for paramedics seeking a career in primary care, outlining the skills and attributes required to become a first contact paramedic or advanced paramedic, in addition to establishing the supervision and governance needed to support them.

In asserting the capabilities of first contact and advanced paramedics, this document assists employers and workforce planners in understanding what this role can bring to the table in a multi-professional team, and thereby support the delivery of the best patient care.

For a detailed breakdown of a first contact paramedic’s scope of practice, please consult the Roadmap to Practice and read:

• Section 3.0: National standards and frameworks for MSK practitioners
• Appendix 12.14: Knowledge, Skills and Attributes document

From April 2021 onward, first contact paramedics can be recruited by PCNs through the Additional Roles Reimbursement Scheme (ARRS). This scheme provides funding for additional roles, enabling the creation of bespoke multidisciplinary teams. All PCNs are eligible for reimbursement funds, with the amount available dependent on their weighted population share.

Through ARRS, paramedics can be employed by PCNs and reimbursed at 100% of defined salary, plus defined costs. More information on this can be found in NHS Confederation’s guide, below.

Additionally, like nurses, nursing associates, and other AHPs, paramedics are entitled to £1,000 of CPD funding over 3 years.

HEE are currently producing case studies for first contact paramedics. Please stand by until they’re ready to be released.

The College of Paramedics (CoP) states that, from 2021 onward, all paramedics should have a BSc (Hons) to be registered with the Health and Care Professions Council (HCPC). This qualification is acquired over 3 to 5 years of study. Paramedics working in advanced practice should be educated to the level of a Master’s degree, however.

The CoP notes that the requirement for higher education qualifications is relatively new, though, with a number of paramedics in advanced practice not having such. The CoP maintains that paramedics aspiring to transition should be educated in line with these requirements — and it is hoped that employers will assist the paramedics they recruit in meeting these standards.

It is also expected that paramedics will have successfully completed a preceptorship programme (or the equivalent of) prior to working in primary care; this is usually done in the first two years after initial registration, via schemes like the Newly Qualified Paramedic (NQP) programme. Completion of a preceptorship is intended to round out paramedics, with experience in assessing and managing an array of patients across the clinical and social spectrum.

First contact physiotherapists employed under the Additional Roles Reimbursement Scheme (ARRS) have a deadline of April 2022 to complete stages 1 & 2 of HEE’s Roadmap to Practice to enable drawing down of funding.

If you are not employed under ARRS, then you do not have this deadline. It is beneficial to complete them, however, if you want to be on the Centre for Advancing Practice Directory — you will need to have gone through stages 1 & 2 before moving on to stage 3 and advanced clinical practice.

Both stages can be completed in general practice and signed off by a verified clinical roadmap supervisor, or you can attend a taught route. You will still need to have evidence of clinical supervision by a roadmap supervisor to ensure competency, though.

The short answer is yes — to access it, a first contact paramedic will need to secure the backing of a GP and their practice manager, before reaching out to the Training Hub. It is then a matter of applying to UWE’s apprenticeship scheme.

For more information, please do contact our ACP Lead, Kerri Magnus, at kerri.magnus2@nhs.net

Please stand by whilst we confirm HEE’s job description for first contact paramedics.

We will provide sample interview questions soon. Thank you for your patience.