Published: 02/06/2005, Volume II5, No. 5958 Page 31

Ambulance practitioner is not just a new role at Billericay, Brentwood and Wickford primary care trust - It is one of only a handful of such positions in the country. The role reflects a commitment to develop intermediate care services to bridge the gap between the primary and acute sectors.

An initial pilot at the PCT showed how a practitioner could contribute to avoiding unnecessary admissions. Jude Weatherill is now testing the theory as part of a one-year evaluation phase.

She spends her days working alongside a paramedic in a rapid response vehicle, allowing her to treat 999 patients at home, work, a GP surgery or elsewhere.

'A lot of people do not want to go to hospital. I can often treat their injuries where they live, ' says Jude. 'Cases like this would otherwise go to casualty.

'On one occasion, having dressed a wound I made a next-day referral to a plastic surgeon. These options provide for better patient pathways and continuity of care.' Where hospital attendance is unavoidable, Jude can refer directly to medical and surgical specialists, bypassing accident and emergency and ensuring more efficient use of resources. Assessing the need for hospital admission from the patients' home and the availability of rehabilitation facilities adds to the range of options at the ambulance practitioner's disposal.

Feedback has been positive.

'Explaining to a patient's family what the options are is a great way of providing reassurance.' And even for an experienced emergency nurse, there is still plenty to learn. 'The nurse and paramedic roles complement each other well and I am always learning. I will take advanced formulary studies soon, and that will allow me to administer a broad range of drugs, ' says Jude.