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Background: A significant proportion of emergency medical services (EMS) work is for problems that may be amenable to timely primary care management and could benefit from GP input. Utilising GPs in EMS may reduce avoidable emergency department (ED) conveyance, releasing emergency ambulances for higher-acuity care, and meeting patient needs earlier in the evolution of an emergency call. Aim: To collate and summarise evidence on how GPs are utilised in EMS. Design & setting: Systematic mapping review and narrative synthesis. Method: A systematic literature search was conducted using search terms for general practice and emergency care. Primary research articles investigating the utilisation of GPs in non-critical EMS were included. An inductive framework was used to structure the results alongside a narrative synthesis. Results: Twenty-one articles were included. GPs were embedded in EMS for urgent management of high-acuity patients or used as an intervention to avoid unnecessary ED conveyance in selected lower-acuity patients. The importance of interprofessional relationships and training for GPs involved in EMS was highlighted. No studies explored patient-reported outcomes. Outcomes measured were predominantly ED non-conveyance and admission avoidance, with GP services as an intervention reducing the likelihood of these outcomes. Conclusion: Embedding GPs in EMS might service different purposes depending on context. There is some evidence that GP EMS services may reduce the likelihood of ED conveyance and hospital admission in selected cases; it is unclear whether this is owing to case selection or GP involvement. Future research should incorporate patients' views and experiences. [ABSTRACT FROM AUTHOR]

Background: General Practice faces pressures due to increased demand and a shortage of GPs. Paramedics in General Practice (PGPs), increasingly contribute to managing minor illnesses, conducting home visits, and providing urgent consultations., Aim: Explore the impact of paramedic-consultations on patient-reported experience, safe management and NHS costs., Design & Setting: Prospective cohort study comparing PGP with GP consultations at 34 GP sites in England., Methods: Eligible participants had a consultation with a PGP (25 PGP sites) or GP (9 non-PGP sites) between May 2022 and February 2023. Questionnaires were provided after the initial consultation and 30 days later. Questionnaires assessed patient experience, outcomes and perceived safety (PCOQ and PREOS-PC), quality of life (EQ-5D-5L) and health care use., Results: Of 715 participants recruited, 489 completed the 30-day questionnaire. We found no evidence that PGP-consultations resulted in greater improvement/deterioration in patient-reported health and wellbeing; confidence in health provision; health knowledge; or confidence in the health plan over the 30-day period. However, the PGP group reported lower confidence in health provision, poorer perceptions of practice engagement in safety promotion and more communication problems with staff immediately after the initial consultation. Patients receiving PGP-consultations reported fewer GP appointments during the 30-day period, however savings to the NHS were offset by higher use of other healthcare professionals., Conclusion: Well-designed training and supervision are needed to ensure PGPs have the right knowledge and can clearly convey health care plans to patients. While PGPs may reduce GP workload pressure, they do not necessarily reduce NHS costs., (Copyright © 2024, The Authors.)