Community First Responders’ role in the current, and future, rural health and care workforce
Funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research Programme, awarded £481,000.
Key contact: Professor Niro Siriwardena
This is a mixed methods study which aims to work with PPI and stakeholders throughout to develop recommendations for future innovations in rural CFR provision by investigating current activity, costs of provision, and views of patients, public, CFR schemes and rural care providers.
| Team | Prof Niro Siriwardena, CaHRU, University of Lincoln Dr Zahid Asghar, CaHRU, University of Lincoln Dr Murray Smith, CaHRU, University of Lincoln Viet-Hai Phung, CaHRU, University of Lincoln Dr Gupteswar Patel, CaHRU, University of Lincoln Dr Julie Pattinson, CaHRU, University of Lincoln Dr Colin Ridyard, CaHRU, University of Lincoln Dr Mehrshad Parvin Hosseini, CaHRU, University of Lincoln Ian Trueman, CaHRU and School of Health and Soial Care, University of Lincoln Amanda Brewster, Healthier Ageing Patient and Public Involvement (HAPPI) group, Lincoln Pauline Mountain, HAPPI group, Lincoln Prof Richard Parish, National Centre for Rural Health and Care |
| Team/consortium | University of Lincoln National Centre for Rural Health and Care East Midlands Ambulance Service (EMAS) NHS Trust West Midlands Ambulance Service (WMAS) NHS Trust Yorkshire Ambulance Service (YAS) NHS Trust South Central Ambulance Service (SCAS) NHS Trust North West Ambulance Service (NWAS) NHS Trust South East Coast Ambulance Service (SECAMB) NHS Trust South West Ambulance Service Foundation (SWAST) NHS Trust |
| Oversight committee | Prof Prof Jeremy Dale, Professor of Primary Care, University of Warwick, Chair Prof Guiqing (Lily) Yao, Professor of Health Economics, University of Leicester Dr Nicholas Taub, Research Fellow in Medical Statistics, University of Leicester Lissie Wilkins, PPI representative, Lincolnshire Dr Tomás Barry GP and Assistant Professor, University College Dublin |
| Overarching aim | The overarching aim is to work with PPI and stakeholders throughout to develop recommendations for future innovations in rural CFR provision by investigating current activity, costs of provision, and views of patients, public, CFR schemes and rural care providers. |
| Objectives | The objectives of this study are to: i. Describe the contribution of CFRs to rural health provision in terms of numbers/timing of calls attended, types of conditions and people attended. ii. Evaluate the costs, funding sources, and consequences of CFR schemes. iiia. Explore ambulance/CFR protocols and guidelines. iiib. Explore stakeholder (patients, relatives, ambulance staff, primary care, commissioners, CFRs and CFR scheme organisers) experiences and perceptions of CFRs’ current role and potential for future developments and innovations. We will also ask CFRs and CFR scheme organisers about challenges and solutions to recruiting, training, retaining CFRs in rural areas and how to ensure governance and accountability for safe, high quality care. iv. Assimilate and integrate data from WP1-3 synthesising these using the ABC (actor, behavioural change, causal pathway) theory to develop a list of recommendations for future innovations. v. Prioritise recommendations for future developments/innovations in rural CFR provision through consensus stakeholder workshop. |
| Methods | We will use mixed methods, underpinned by a robust theory, the ABC framework, and five linked work packages |
| Outcomes | We will provide feedback tailored to each participating ambulance service and CFR schemes in that region as well as a report of findings to the funder, peer reviewed research articles, conference presentations, together with blogs, infographics and social media to publicise the findings to lay and professional audiences including CFR scheme leads, ambulance leads, commissioners, academics, policy experts with an interest in this area and the public.. |
| Outputs | Siriwardena AN, Patel G, Botan V, Smith MD, Phung VH, Pattinson J, Trueman I, Ridyard C, Hosseini SMP, Asghar Z, Orner R, Brewster A, Mountain P, Rowan E, Spaight R. Community First Responders’ role in the current and future rural health and care workforce: a mixed methods study. Health and Social Care Delivery Research 2024. Botan V, Asghar Z, Rowan E, Smith MD, Patel G, Phung VH, Trueman I, Spaight R, Brewster A, Mountain P, Orner R. Community first responders’ contribution to emergency medical service provision in the United Kingdom. Annals of Emergency Medicine. 2023; 81:176-83. Patel G, Phung VH, Trueman I, Ørner R, Siriwardena AN. Common hierarchies, varied rules – The problem of governing community first responders in prehospital care for quality standards: documentary discourse analysis. BMC Health Services Research 2023; 23: 38. Patel G, Phung V, Trueman I, Pattinson J, Botan V, Hosseini SMP, Ørner R, Asghar Z, Smith MD, Rowan R, Spaight R, Evans J, Brewster A, Mountain P, Siriwardena AN. “It’s like a swan, all nice and serene on top, and paddling like hell underneath”; Community First Responders’ practices in attending patients and contributions to rapid emergency response in rural England, United Kingdom: a qualitative interview study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2023; 31:7. Orsi A, Watson A, Wijegoonewardene N, Botan V, Lloyd D, Dunbar N, Asghar Z, Siriwardena AN. Perceptions and experiences of Medical Student First Responders: a mixed methods study. BMC Medical Education 2023; 22:721. |
| Impact | We have created impact by developing recommendations and informing policy for future development of CFRs and CFR programmes. |