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Cardiff and Vale’s first Paramedic Practitioner can prescribe for patients

Vivian Carley, Cardiff and Vale’s first Paramedic Practitioner

Cardiff and Vale’s first paramedic practitioner, Vivian Carley, has achieved an Independent Prescribing qualification, thanks to Cardiff and Vale University Health Board.

Mr Carley, who resides at Llantwit Fadre, has been working in the urgent care out-of-hours centre at Cardiff Royal Infirmary since 2018. Now, thanks to his newly-achieved qualification, Vivian can prescribe certain medications for patients who have urgent care needs outside of General Practice working hours, reducing the wait and need to see a GP for patients.

The qualification, offered to the health board employee as he held a Master’s degree in Advanced Clinical Practice, consists of a clinical log, 3,500 word assignment, a critical appraisal and two exams; calculations and multiple choice. Viv started the course eight months after he joined the health board in September 2018, before completing it May last year.

“The biggest challenge to the qualification was getting through all the work as you have to spend time with your mentor, manage clinical hours as part of your work placement and get the assignments done. However, I was grateful to the health board as they granted me study leave and I could work in between shifts.

“The multiple choice exam was the most difficult element; you had to gain an overall 80% pass mark and the exam covered such a wide scope of medicine including pharmacology you’ve never worked with before”, said Viv.

The 56 year old is no stranger to the healthcare setting; he worked at Welsh Ambulance Services for 33 years, working his way to become a supervisor in charge of 13 staff. During his time there, he completed his basic and advanced life support courses early on in his career before gaining a Master’s degree in 2013.

“I first thought of becoming a paramedic when I was working in the stores at Dewi Sant hospital, Pontypridd. I used to see the paramedics coming in and liked the image of them in their uniforms; I know I wanted to be a part of this so I applied for a job with the ambulance service.”

Viv made the decision to leave the service, his employer since he was 22, to do something different that still relied on his medical knowledge. However, the career change came with its challenges.

“Be prepared to work out of your comfort zone. I see 24-30 patients a day in assigned 20 minute slots whereas when working for the ambulance service I would see 4-8 a day and you’d need to respond rapidly and rush off to that person.

“However, in out of hours, you get to work with a team of other healthcare professionals and ask for advice. I’ve grown in confidence since working here and my knowledge of minor illnesses has increased. When working as a paramedic, we’d only see the patient for the first part of their journey, taking them to the hospital. Now, I see the patient’s full journey as I usually meet patients who I triage face-to-face and prescribe for them”, added Viv.

The addition of the qualification has been a positive one for the clinical practitioner, although he was dubious to start the course at first.

“When studying, I worked with nurses and other medical staff so I had an insight into different aspects of healthcare. I’ve built on my existing knowledge and increased my scope of practice; I can now do more for my patients so they only see one healthcare professional when discussing their needs rather than multiple people.

“The qualification has definitely given me better job satisfaction. Not only that but it’s enjoyable and given me the motivation and confidence in my decision making, ideal for those wanting to develop in their existing role. I’d like to thank the health board for the support to enable me to achieve this”, concluded Viv.

Kay Jeynes, Director of Nursing for the Primary, Community and Intermediate Care Clinical Board at Cardiff and Vale UHB said, “What a fantastic achievement for Viv. The clinical board were only too happy to support our first paramedic practitioner with this commendable qualification. It’ll be great to see Viv integrate the prescribing into practice, helping alleviate the waiting time and pressures on the urgent care out-of-hours service so patients get the most appropriate treatment with the right clinician, more efficiently. Congratulations again, Viv!”