Background With increasing demand on community palliative care services, combined with ongoing difficulty recruiting palliative CNSs, working models of care need to change. Paramedics have holistic skills beyond those involved in immediate life-saving, with knowledge of a wide variety of medical, surgical and mental health presentations. Paramedics are adept at physical assessment, symptom management, signposting and advanced communication, often in crisis situations. Recognising that these skills are transferable, our organisation set out to employ paramedics within band 6 development posts.

Aim To employ a paramedic to integrate within the community team, develop the role of a Clinical Specialist Practitioner (CSP) in palliative care, and alleviate the future anticipated workforce crisis.

Method The Band 6 CSP Development post was created to give opportunity for paramedics to develop the required specialist palliative care skillset. The post holder followed a 1-2 year programme of development (dependent on experience) to attain levels of knowledge and skill through a set of competencies working alongside Band 7 Clinical Nurse Specialists and the medical team.

Results The hospice has successfully employed two paramedics. Not only have they progressed clinically into Band 7 roles, but they demonstrate excellent leadership skills, both having taken on locality caseload team leader positions. Their skillset allows them to work across roles from new referrals received in Hospice Point of Contact, telephone triage, OOH weekend work, to routine and responsive community visits.

Conclusion Multi-disciplinary working in hospices is well established, but has not traditionally included paramedics. The specialist skillset paramedics bring lends itself well to working within the hospice community team. While the role of the paramedic is still in its infancy, we hope our adoption of bespoke CSP roles will help to inspire other palliative organisations struggling with workforce crises to consider expanding their workforce through the employment of paramedic colleagues.