Developing A Complex Intervention to Integrate Community Paramedics in GP Out-of-Hours Care in Ireland: A Qualitative Study

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Abstract
Background Significant workforce challenges are evolving in Irish general practice, which limit all aspects of practice, especially out-of-hour care. Community Paramedics can support general practitioner (GP) out-of-hour care and potentially improve the system efficiency in Ireland. Methods Qualitative semi-structured interviews were conducted with purposively recruited participants using a schedule informed by the existing research. A thematic analysis was undertaken based on the Braun and Clarke approach and supported by the NVivo software. Themes were developed based on the concept of preliminary key model components. The study was conducted in accordance with Standards for Reporting Qualitative Research. Results Comprehensive data analysis generated four major themes: Workforce Management, Synergies in Healthcare, Progressive Futuristic Care, and Safe Practice. These themes formed the basis for the further development of the preliminary key model components. Conclusion This study suggests that the integration of Community Paramedics into GP out-of-hour care in Ireland can be successfully launched if workforce planning is carefully considered. The role of the Community Paramedic must be defined, regulated, and governed in conjunction with the National Ambulance Service, the Pre Hospital Emergency Care Council, and the Department of Health in Ireland. Patient care must be underpinned by safe and effective care practices that are continuously audited and evaluated, and the scope of practice must be defined and maintained by each Community Paramedic through a guided educational system that incorporates continuous professional development. GPs can provide support to community paramedics, including the use of information technology, as required. GPs and Community Paramedics can work together to synergize healthcare and provide safe and effective care to patients in the domiciliary setting during out-of-hour hours, thus reducing emergency department attendance and increasing the GP’s capacity to provide face-to-face consultations.
Funding Information
  • Health Research Board (CSF-2020-006)
  • Health Research Board (ECSA-2024-002)

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