Across our region, teams of paramedics work within our communities providing out-of-hospital care for thousands of patients and supporting the wider healthcare system across the North East.
Recently, we followed Teesdale community paramedic Richard York for a shift out in the community to see what a day on-shift looks like for him and his colleagues.
Our community paramedics work with the local GP surgeries in the area, supporting the practice staff with the ever-increasing demands on their services by visiting patients at their homes and treating them at home wherever possible.
Richard’s shift begins as all operational colleagues shifts do; getting in early to his station to do a kit and drugs bag check. Unlike our regular ambulance crews, Richard’s qualifications and experience as a community paramedic means he has access to more medication that allows him to treat patients from home and prevent unnecessary and sometimes distressing visits to hospital.
Throughout the shift, Richard visits several elderly and vulnerable patients who benefit from the familiarity of care at home, including 97-year-old Bill who is a World War Two Royal Navy veteran and a regular on Richard’s lists of patients. For the elderly and end-of-life-care patients that he visits regularly, Richard provides a lifeline of support and, importantly, a friendly and familiar face. Speaking to Bill in his home, we asked what impact Richard’s care had on him: “I look forward to seeing [the community paramedics] and we’ve become friends. I can tell Richie everything, he takes very good care of me. I’ve obviously been to hospital, but I want to stay at home.”
But it isn’t just the patient who benefits from his care, Richard adds: “I don’t care if I have to go back to a patient two or three times to support them because it’s the right thing to do for that patient. That’s especially true for end-of-life patients, where I think we’re able to make a real difference for them and their families. For some end-of-life patients, we have gone back twice a day to see if they or their families need anything. You might not be able to do anything to save their lives, but let’s make them comfortable at the end of it.”
The relationships built with patients and their families is crucial to being able to provide the best care for them. At the very beginning of the shift, Richard visits an elderly patient who he visited the day prior. Her blood test results are back from the doctors, and she needs to go to hospital. Hospital can be a scary visit for elderly patients who are vulnerable to picking up infections more easily, and the patient will need a bit of convincing but if she doesn’t go, she will likely die.
Much like that of our operational crews across the region, the work of the community paramedic often goes far beyond the job description. In times of crisis, that they are a cornerstone of care in their communities. As Richard explains: “Storm Arwen really showed the importance of our community paramedic team, not just here but in Weardale too. We had patients who couldn’t get out of the house and a lot of them had no heating, so we just got stuck in. We visited each GP practice and got a list of patients who needed to be checked on then, once we had checked on them, we liaised with the council and fire service to make sure they had care packages and generators if they didn’t have any heating.”
The interconnectivity of working with GP practices allows Richard and his colleagues to have a real influence on the long-term care of their patients. Richard says: “A lot of the time our patients underestimate what’s wrong with them, but they don’t want to be a bother and they are frightened to go to hospital. I’m able to do something to support that.
“When you’ve got the ambulance service working on one hand and doctors working on the other, it can sometimes feel like we’re working against each other despite us all having the patients’ best interests at heart. With this way of working, we work together as one team. As well as being better for the patient, ensuring we’re meeting their needs, it’s also better for the system because we’re utilising our resources more effectively and ultimately reducing demand on the ambulance service and emergency departments.
“Yes, we do sometimes still have differences of opinion, but we have a much better understanding of each other’s expertise and how we can work together to support our patients. It’s a really nice and supportive environment to work in, and I even get invited to Christmas dinner!”
Fellow community paramedic, Tanya O’Connor, who joined the community paramedic scheme in February 2023, agrees: “The elderly population don’t want to go to hospital and it is possible to treat them in their own homes when we understand their point of view and work with their families and our local GPs and district nursing, Macmillan and Marie Curie teams. We can treat their infections and organise blood tests and scans for them and ensure they only go to hospital if they really need to.
“A lot of the jobs we get are the same as the ones a regular ambulance crew gets; the difference is we can usually do something about it on a longer-term basis.”
For Old Forge Surgery doctor and partner, Dr Chris Markwick, the relationship is equally as beneficial to him and his practice colleagues. He said: “We cover quite a large geographical area and many of our patients are incredibly rural. Having the community paramedics to go and see patients frees us up to see more patients in the practice and helps our patients get a really good continuity of care as the paramedics really get to know our community.
“If I have a patient who is borderline being admitted into hospital, the team can visit them and keep an eye on them, ensuring they receive the care they need and hopefully preventing an unnecessary hospital admission.”
Thank you to Richard, the Teesdale community paramedics, and the staff at Old Forge Surgery for such an eye-opening experience into the incredible work that you do to ensure our patients are safe and their wellbeing is cared for 24/7, 365 days a year.