ARRIVE: Ambulance paramedics Responding to urgent patient Requests In general practice for home Visits — Evaluation development

Background In response to rising demand for health care and limited availability of GPs, paramedics are increasingly working in general practices, most commonly to carry out home visits. UK policy supports this change which involves role substitution across professional groups and sectors of care. In Wales, schemes have been introduced over the past few years, with various configuration, employment, and governance arrangements, but we do not know the risks and benefits of Paramedics working in Primary Care (PPC), or which model works best. There is an urgent need to better understand the PPC innovation. Aim To describe the evidence base, theoretical underpinning and current initiatives; and determine the feasibility of undertaking a definitive evaluation of PPC in order to produce generalisable evidence to inform policy and practice. Method A survey of Welsh Health Boards has been undertaken to identify sites and stakeholders to take part in qualitative interviews. A feasibility study will be conducted with three GP practice sites: one with a directly-employed paramedic; one with a Welsh Ambulance Service-employed paramedic; and a control site. Data will be collected for the following outcomes: 1) number of home visits requested; 2) home visit outcomes (the proportion resolved, further home visit required, emergency admission, 999 call placed); 3) prescribing patterns; 4) subsequent healthcare contacts; 5) patient satisfaction; 6) serious adverse events; and 7) cost profile. Results Welsh Health Board survey and qualitative findings will be available at the time of the conference. Conclusion We will submit an application for a fully powered application to NIHR HS&DR if indicated by our progression criteria.