Paramedics in general practice in Cornwall: what roles and what work do they undertake?

INTRODUCTION: General practice faces increasing pressure, especially in deprived rural areas (Laccobucci, 2019). The Additional Roles Reimbursement Scheme (ARRS) was introduced to employ extra health professionals, including paramedics, to support the delivery of general practice services. In Cornwall, over 60% of general practices employ paramedics, as identified in a preliminary search of general practice websites by the author. However, it was unclear what roles and tasks they undertook and how they were funded. This study's aim, the first to focus on a specific rural area in the UK, was to explore these questions. METHOD: Data from a cross-sectional online survey were collected between June and September 2024. Respondents were HCPC-registered paramedics employed in general practice in Cornwall. They were invited to complete the survey via the Cornwall Primary Care Training Hub. Quantitative data were analysed using descriptive statistics, while qualitative free-text responses were collated and examined for patterns. RESULTS: Of the 62 invitees, 37 provided valid responses (60%). Fourteen (38%) were non-medical prescribers. Thirteen (35%) were ARRS funded, and 13 different job titles were used. All of them saw patients identified as urgent in a clinic or at home; four (11%) were employed specifically as part of a home visiting team and four (11%) as members of a multidisciplinary hub / same-day service. CONCLUSION: This was the first survey to investigate the roles and work of paramedics in general practice within a specific area of the UK. It highlighted training needs and raised questions about employment models, non-medical prescribing, funding and job titles. Addressing some of these questions would provide greater clarity and increase recognition of the paramedic role in general practice, while also potentially informing workforce planning.