Job summary
An exciting opportunity to join an established and forward-thinking Paramedic Team

Are you an experienced Paramedic looking for an opportunity to develop your career within Primary Care?

North Wilts Border Primary Care Network is looking for an enthusiastic, skilled and motivated PCN Paramedic to join our dynamic multidisciplinary workforce.

You won't be working alone. You will become part of an established team of six experienced PCN Paramedics, providing the opportunity to work collaboratively, share clinical knowledge and experience, and learn from colleagues while continuing to develop your own scope of practice.

Our PCN brings together six GP practices across North Wiltshire and Swindon, and we have developed a diverse multidisciplinary workforce focused on delivering high-quality, proactive and accessible care closer to patients' homes.

This is an excellent opportunity for a Paramedic who enjoys autonomy, variety and clinical decision-making and wants to play an important role in shaping how care is delivered within Primary Care.

We are looking for a Paramedic who is clinically confident, compassionate and comfortable working autonomously while recognising when to seek advice or escalate care.

You will need current HCPC registration as a Paramedic, strong clinical assessment and decision-making skills, and experience appropriate to autonomous Primary Care practice.

Main duties of the job
As a PCN Paramedic, you will work autonomously as part of our wider multidisciplinary team, assessing and managing patients presenting with a broad range of acute, undifferentiated and complex conditions.

Your role will include same-day and urgent care, home visiting, frailty and complex care, with opportunities to work within GP practices, patients' homes, care homes and other community settings.

You will undertake comprehensive clinical assessments, formulate differential diagnoses, identify and manage clinical risk, initiate treatment and investigations within your competence, and refer or escalate patients appropriately.

A key part of the role will be supporting patients to receive the right care, in the right place, at the right time, helping to avoid unnecessary hospital attendance or admission where safe and clinically appropriate.

You will work closely with GPs and our wider PCN multidisciplinary team, including nurses, clinical pharmacists, pharmacy technicians, care coordinators, social prescribers, health and wellbeing staff, mental health practitioners and other allied health professionals.

Depending upon your experience and competence, there may also be opportunities to contribute to areas such as care-home support, ward rounds, frailty, anticipatory care, service development, quality improvement and the ongoing development of our PCN Paramedic service.

About us
North Wilts Border Primary Care Network is an ambitious and evolving organisation where our people are central to what we do.

We work collaboratively across six GP practices:

• Malmesbury Primary Care Centre,
• New Court Surgery,
• Purton Surgery,
• Cricklade Surgery,
• The Tolsey Surgery
• Tinkers Lane Surgery.

We have invested significantly in developing a broad multidisciplinary workforce to include GP, Care Coordinators, Social Prescribers, Clinical Pharmacists and Pharmacy Technicians and believe that bringing different professions, skills and perspectives together enables us to provide better care for our communities.

For this role in particular, you will have the benefit of joining an established team of six other Paramedics. We recognise the importance of peer support, clinical supervision, shared learning and professional development, particularly when working autonomously in Primary Care.

We want our clinicians to feel able to contribute ideas and help shape services rather than simply step into a fixed model of working. As our PCN continues to develop, there will be opportunities to contribute to service improvement and new ways of delivering care across our practices and communities. The role specifically includes participation in service development, quality improvement, audit and evaluation.

Job responsibilities
Key clinical responsibilities

• Assess and triage patients, including same-day and urgent presentations, and provide definitive treatment or appropriate onward referral
• Undertake face-to-face, telephone and, where appropriate, digital consultations in practice, patients homes, care homes and other community settings
• Undertake comprehensive history taking, physical examination and clinical assessment for patients with acute, chronic, complex or undifferentiated presentations
• Formulate differential diagnoses, identify red flags, assess clinical risk and determine the appropriate level and place of care.
• Initiate emergency care and escalation when required, including referral to ambulance, urgent community, secondary care or specialist services
• Treat minor illness and minor injury within competence and agreed local pathway
• Undertake and interpret appropriate investigations within competence, which may include observations, ECGs, urinalysis, blood glucose/ketones, blood tests, swabs and other point-of-care or diagnostic procedures available within the PCN
• Request, review and act on investigations where authorised and competent to do so, ensuring appropriate follow-up and safety-netting.

Provide clear safety-netting advice, including when and how patients or carers should seek further or urgent help

• Provide health promotion, prevention and self-management advice and support shared decision-making
• 3. Home visiting, frailty and proactive care
• Provide an alternative model for urgent and same-day home visits across the PCN, prioritising workload according to clinical need and risk
• Assess housebound, frail and vulnerable patients, including those with multimorbidity, deterioration or complex health and social care needs
• Contribute to care home support and ward rounds where this forms part of the agreed PCN service model
• Support anticipatory and personalised care planning, including escalation planning and coordination with the wider multidisciplinary team
• Identify opportunities to prevent avoidable hospital attendance or admission while recognising promptly when escalation is clinically necessary
• Work with community, urgent care, virtual ward, ambulance, pharmacy, social care, voluntary sector and other services to coordinate appropriate care.
• 4. Medicines management and prescribing
• Administer medicines in accordance with legislation, local policies, Patient Group Directions (PGDs), Patient Specific Directions (PSDs) and professional scope of practice
• Where appropriately qualified as an independent prescriber, prescribe, review and deprescribe medicines within competence and in accordance with NICE guidance, local formularies, antimicrobial stewardship principles and PCN/practice policies
• Provide patients and carers with appropriate information about medicines, including purpose, adherence, side effects, interactions and when to seek further advice.
• Recognise personal limits in relation to medicines and seek advice from GPs, clinical pharmacists or other appropriate clinicians when required.
• 5. Multidisciplinary and integrated working
• Work as an integral member of the PCN multidisciplinary team, collaborating with GPs, nurses, pharmacists, pharmacy technicians, care coordinators, social prescribers, health and wellbeing staff, mental health practitioners and other allied health professionals
• Accept appropriate referrals and refer patients to other clinicians and services according to clinical need and agreed pathways.
• Communicate proactively and effectively with practices and partner organisations to ensure coordinated, person-centred care.
• Attend and contribute to PCN, practice, MDT, clinical, safeguarding, education and service-development meetings as required.
• Promote effective professional relationships across organisational boundaries and contribute to integrated neighbourhood working.

Person Specification
Clinical knowledge & skills
Essential

• Advanced history taking, clinical examination and assessment skills
• Ability to recognise deterioration, red flags and emergencies and escalate appropriately
• Ability to formulate differential diagnoses and evidence-based management plans within competence
• Understanding of safeguarding, consent, capacity, confidentiality and information governance
• Knowledge of medicines safety and relevant legal/professional frameworks
• Ability to document clearly, code accurately and provide robust safety-netting

Desirable

• Competence in ECG interpretation, phlebotomy and relevant point-of-care diagnostics
• Knowledge of frailty, anticipatory care, personalised care and admission avoidance pathways
• Knowledge of QOF/IIF and wider PCN contractual priorities

Other requirements
Essential

• Able and willing to travel between PCN sites and undertake home/community visits
• Ability to meet the physical and practical requirements of the role, with reasonable adjustments where required
• Satisfactory DBS and occupational health clearance as required

Desirable

• Full UK driving licence and access to a suitable vehicle, subject to reasonable adjustment and organisational policy

Qualifications
Essential

• Master Level (Level 7) or working towards it.
• Has been signed off formally within the clinical pillar competencies of the paramedic FCP/AP roadmap to practice.
• Degree/diploma in Paramedic Science/Paramedicine or equivalent recognised qualification/experience
• Has a further three years experience as a band 6 (or equivalent) paramedic
• Current HCPC registration as a Paramedic
• Meets current eligibility requirements applicable to the role and funding route
• Evidence of relevant CPD and maintenance of professional competence

Desirable

• Independent/non-medical prescribing qualification
• Masters-level qualification or modules relevant to advanced practice
• Formal evidence of FCP/AP roadmap completion or equivalent advanced-practice recognition

Experience
Essential

• Substantial post-registration paramedic experience appropriate to autonomous primary care practice
• Experience assessing and managing a broad range of acute and undifferentiated presentations
• Experience of autonomous clinical decision-making and managing risk/uncertainty
• Experience of home/community visiting and managing patients with complex needs
• Experience of multidisciplinary working

Desirable

• Primary care/general practice experience
• Care home, frailty or urgent community response experience
• Experience of SystmOne
• Experience of audit, quality improvement, teaching or supervision

Personal attributes
Essential

• Able to work autonomously while recognising limits and seeking support appropriately
• Organised, adaptable and able to prioritise a variable workload
• Calm and effective under pressure
• Reflective, accountable and committed to continuous improvement
• Commitment to equality, diversity, inclusion and person-centred care

Desirable

• Evidence of contributing to service redesign or new models of care

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
Applicants must have current UK professional registration.