Author: Baker, Ria (ria.baker@canterbury.ac.uk)

Increasing Capacity:
Making Practice Education Meaningful and Relevant for the Wider Health and Social Care Economy

Ria Baker
Senior Lecturer in Practice Learning
Canterbury Christ Church University

Background:
With the changing face of pre-registration education and training, alongside the evolving roles of professional practitioners within the health and social care arena (Department of Health, 2016), it is timely to explore how we can provide meaningful and relevant practice education opportunities to our pre-registration students, the focus for this submission is for those undertaking the BSc (Hons) Paramedic Science degree as a route to registration with the Health and Care Professions Council (HCPC) as a Paramedic.
The vision for Transformation of Ambulance Services set out in Taking Healthcare to the Patient (Department of Health, 2005) recognised the need for the delivery of a range of services from responding to and treating acute trauma, to the delivery of preventative health promotion. Knowledge of services and referral processes can only support these developments. The paramedic programme at Canterbury Christ Church University recognises the valuable contribution of experiences that develop wider knowledge of community based services supporting practitioners to make safe, effective decisions for patients in their care. With the changing face of pre-registration education and training, alongside the evolving roles of professional practitioners within health and care (NHS England, 2015), it is timely to explore how we can provide meaningful and relevant practice education opportunities to our pre-registration students. The focus here is for those undertaking the BSc (Hons) Paramedic Science degree as a route to registration with the Health and Care Professions Council (HCPC).

Aim:
The aim of this piece of work was to examine the development and implementation of practice opportunities within primary health services, mirroring the ‘Taking Healthcare to the Patient’ review of 2011, which sets out a vision for the ambulance services to provide an increase of primary care services.

Pilot Group Focus:
During the second year of their studies our current paramedic students, on the direct entry route, already have the opportunity to attend “alternative placements in community settings”. Therefore, it was agreed that this would be the most appropriate opportunity to expose them to the primary care services. Across an 8-week period commencing in January 2017, 22 students from the April 2015 Paramedic Science Cohort will spend two weeks of practice placement (75 hours) in a GP surgery within three localities in Kent; Thanet CCG (Clinical Commissioning Group), South Kent Coast CCG and Canterbury and Coastal CCG.

Consultation & Implementation:
During the consultation phase the opportunity for our students to spend two weeks in primary care was discussed with relevant stakeholders. The collective vision was that it would allow them to enhance their knowledge of the primary care sector, and begin to examine the interface with their role as a paramedic upon qualification. Alongside this was the notion that offering this experience at pre-registration level might encourage individuals to become qualified paramedic practitioners in the future. The two-week timetable provides them with an opportunity to increase their knowledge concerning quality and governance processes, observe and understand triage, participate in chronic disease management through clinics such as COPD, CHD and diabetes. The students will also have the opportunity to observe the ANP/AHP role, and attend home visits/care home visits.

Draft Timetable (week 1):

Monday	Tuesday	Wednesday	Thursday	Friday
Meet Practice Manager or / Designated Lead / Orientation to the Practice. To include HR, Processes, Health & Safety and Governance / Meet Reception Staff and observe function of Receptionist.	Observation of GPs Role / 12:00 – 13:00 – Potential to / attend Home visits/ Care Home visits / Observation of GPs Role / Observe Triage Clinician/GP/ANP.	Observe Receptionist Triage / 12:00 – 13:00 – Potential to / attend Home visits/ Care Home visits / Observation of Health Care Assistants role	Observation of Chronic Disease / Management Clinics (e.g. Asthma, COPD, CHD & Diabetes) / Observation of Chronic Disease / Management Clinics (e.g. / Asthma, COPD, CHD & Diabetes)	Observation of ANP/ AHP role / 12:00 – 13:00 – Potential to attend Home visits/ Care Home visits / Observation of ANP/ AHP role

Evaluation & Moving forward
Upon completion of the practice placement within primary care the students were given the opportunity to fill in evaluation forms. The students also attended a focus group session. This allowed us to glean quantitative feedback via the evaluation whilst having the opportunity to undertake in-depth discussions about the usefulness of the practice placement. Student discussions have let us recognise that the practice experience was incredibly useful for understanding the role of the paramedic in relation to primary care, whilst also understanding the workload within a primary care setting. There were a few teething problems, for example; when multiple students were scheduled in to be with the audiologist, but these were solved with the support of the supervisor and practice manager. The next step is to finish thoroughly evaluating the pilot– with both the students and practitioners, and then to plan a way forward to ensure that all Paramedic Science students at Canterbury Christ Church University will access practice experiences within primary care.

Student Comment
“The placement was actually a lot better than I though it would be. We had a predetermined way of thinking about our own GP, and hadn’t realised the amount of work that happens. The team at Eastcliff were very good, and accommodating. I got a lot out of the placement within primary care.”
Edward Ashby, 2nd Year Paramedic Science student placed at East Cliff Medical Practice, Ramsgate.

Practice Comment
“It was a very good two weeks and we managed to make sure our student linked in with the doctors, nurses and engaged with home visits. Also, sitting in with specialist clinics, ENT, minor surgery. I think it has given them a clearer idea of what Primary Care does and how it integrates with their role.”
Phillip Shaba, Clinical Nurse Lead at Northgate Medical Practice, Canterbury.