Community paramedicine brings more efficient healthcare to rural Scotland and Ireland

By bringing together the national ambulance services of the Republic of Ireland, Northern Ireland, and Scotland, the cross-border community paramedic project, aims to improve rural access to healthcare in the pilot regions. The project is part of the Co-operation and Working Together (CAWT)-led suite of health and social care projects funded by the EU’s INTERREG VA programme.

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The cross-border community paramedic project team. ©Cross Border Community Paramedic Project The cross-border community paramedic project team. ©Cross Border Community Paramedic Project

" This project, involving ambulance services from the three regions working together, is enhancing the health and social wellbeing of citizens in more rural and isolated areas and is enabling the transition from traditional institution-based service provision to a more community-based approach. The valuable EU funding investment provided by the Special EU Programmes Body is supporting the health services to implement joint cross-border solutions to issues that affect citizens in the border region. "

Bernie McCrory, Co-operation and Working Together (CAWT) Chief Officer

In remote and rural areas of Scotland, Northern Ireland, and the Republic of Ireland, patients must use busy hospital emergency medical services (EMS) for emergency healthcare treatment. This can create a burden on EMS personnel and health systems. 

One possible solution is community paramedicine, a relatively new healthcare model that trains paramedics and emergency medical technicians (EMTs) to provide public health, primary healthcare, and preventive services in a patient’s home or community, rather than at a hospital.

Seeing an opportunity to improve healthcare in these rural, border regions, this project is training EMTs to become community paramedics.

Collaboration as a cornerstone 

The collaboration and the sharing of best practices between the three national ambulance services has been a cornerstone of the project. For example, while Northern Ireland and the Republic of Ireland had never trained any community paramedics prior to this project, the Scottish Ambulance Service had started doing so in conjunction with Glasgow Caledonian University. This project leverages the university’s experience and provides all three services with a foundational specialist paramedic course. 

The project provided all community paramedics with new vehicles designed and equipped to provide care to patients in their home. This means that, within the pilot areas, more patients can be treated at home instead of having to be taken by ambulance to hospital emergency rooms.

The pilot areas include Buncrana (County Donegal) and Clones (County Monaghan) in the Republic of Ireland, Castlederg (County Tyrone) in Northern Ireland, and Mid-Argyll in Western Scotland. 

More efficient, effective care 

Although still a work in progress, citizens across the cross-border region are already benefitting from enhanced care. The project is enabling patients to access care and treatment that previously would have been delivered in a distant hospital emergency department. Instead, the newly trained community paramedics deliver treatment to patients more efficiently and effectively. With people aged between 81 and 90 consistently making up the largest group of patients, this increased efficiency can be critical. 

To date, the community paramedic project has resulted in nearly 85 % of all patients served not having to be ferried to a hospital. Considering that prior to this project all of these patients would have been stabilised and transported to hospitals, it shows how this service eases some of the pressure facing emergency departments.  

Beneficiaries

“Community Paramedics are now available to come to my father’s home and attend to his needs in a short space of time. When we made contact with this service, the Community Paramedic arrived and treated my father quickly and without much discomfort. The paramedic’s expertise and care was a pleasure to witness. This is an efficient, professional service which reduces pressure on hospital emergency departments and allows the safe care of my father in his own home.”


Son of a father in his 90s living in the border region of Ireland

 

“This initiative has afforded me the opportunity to become a more integral part of patient care within primary care. The enhanced role promotes the management of both acute and chronic medical conditions within the community, reducing the requirement for emergency transportation and hospital admission. To experience the delight and relief of patients, both young and old, when told that we can deal with their condition at home, rather than at a hospital, suggests that progressing this model of care is essential.”

Brendan Finan, Community Paramedic with the National Ambulance Service of Ireland

Total investment and EU funding

Total investment for the project “Cross border Community Paramedic Project” is EUR 1 922 574, with the EU’s European Regional Development Fund contributing EUR 1 634 188 through the “Interreg V-A - United Kingdom-Ireland (Ireland-Northern Ireland-Scotland)” Operational Programme for the 2014-2020 programming period. The investment falls under the priority “Health”.

 

Draft date

19/09/2019