Keeping patients at home: lessons for UK paramedics

Standfirst: A Danish study found that professionals welcomed paramedic-staffed assessment units, but patient selection, responsibility and follow-up remained difficult. For UK ambulance crews, the useful lesson is to consider both the assessment and what happens afterwards.

Information checked: 5 October 2026.
Evidence: A mixed-methods study of professional experiences in one Danish region. It did not measure whether the service improved patient safety or reduced admissions. UK practice suggestions below are editorial interpretation, not a validated non-conveyance checklist.

 

The study in brief

Three prehospital assessment units in Southern Denmark were each staffed by one paramedic, operated daily from 08:00 to 19:00, and could not transport patients. Their role was to assess, treat and direct patients towards appropriate care. Non-conveyance generally involved physician consultation, with selected conditions managed under established protocols (Rasmussen et al., 2026).

Researchers collected questionnaire data from April to August 2024 and held three focus groups in June 2024. Of 447 invited professionals, 231 responded (51.7%). After excluding 54 without experience of the service and 11 with incomplete outcome responses, 166 entered the analysis. The focus groups involved 18 professionals.

Staff generally rated the model positively:

Source: Rasmussen et al. (2026), Table 3; n = 166. Scores summarise professionals’ perceptions. The interquartile range covers the middle 50% of scores, not a confidence interval.

What mattered in practice?

Selecting patients was not straightforward

Professionals differed over who should receive an assessment-unit response. Once on scene, patient preferences, relatives’ ability to help and the home environment could change the disposition decision.

An unsustainable home situation also created tension: paramedics described arranging hospital transfer, while emergency department staff questioned whether their service could resolve the underlying problem.

Follow-up depended on resources and clear responsibility

Community teams brought knowledge of patients’ usual mobility, eating, toileting and daily functioning. That wider picture could influence the plan beyond the immediate assessment.

Participants also described limited follow-up resources and uncertainty about responsibilities. Emergency calls took priority over less urgent requests, affecting assessment-unit availability.

Shared discussion helped services understand each other

Professionals used the focus groups to explain their roles and discuss gaps, including documentation responsibilities. The authors interpreted these exchanges as helping build understanding, but did not test whether they improved outcomes.

What can UK crews take from this?

A proposed home-care plan needs support that is actually available. The following questions translate the findings into a learning aid. Use them alongside your current local pathways and scope of practice.

These issues align with HCPC paramedic standards on appropriate referral (4.10), records (9.1), safety-netting (13.14), management timescales (13.17), and functional and psychosocial assessment (13.19–13.20) (HCPC, 2023). EMTs should apply the learning within employer-defined responsibilities and escalation arrangements.

How much confidence should we place in it?

The study combines numerical ratings with discussion across services, helping explain why a popular model can still encounter operational problems. However:

• It covers one Danish region. UK roles, referral arrangements and community capacity differ.
• Participation was selective. Only six general practice physicians entered the outcome analysis; one attended a focus group. No medical dispatchers attended the groups.
• It collected professional perceptions, without directly collecting patient or relative experiences.
• It did not measure mortality, adverse events, recontacts, admission reduction or cost-effectiveness.

There is also a reporting discrepancy: the narrative gives general practice physicians’ median acceptability as 5.00, while Table 3 gives 4.13 (IQR 4.00–4.50), n = 6. The overall scores agree across the abstract, narrative and table. Check the final edited paper for any corrections.

Editorial view (EMSUK): The value is in prompting better questions about the whole care pathway. The study does not prove that this model is safer or more effective. For service leads, it supports reviewing selection criteria, handover agreements and follow-up processes rather than judging success by non-conveyance rates alone.

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Check your understanding

1. A plan depends on a relative providing support. What should you clarify?
A. Whether the relative is present, regardless of their ability to help.
B. Whether they can realistically provide the support required and what happens if they cannot.

2. A community referral has been sent. What still needs clarification?
A. Acceptance where required, responsibility, response times and arrangements if care is delayed.
B. Nothing further, because sending a referral guarantees follow-up.

3. What do the study’s positive ratings establish?
A. Reduced mortality and fewer adverse events.
B. Positive perceptions among the included professionals.

Answers: 1: B, because presence does not establish ability to help. 2: A, because referral submission alone does not establish that care will occur. 3: B, because this study assessed implementation perceptions, not clinical outcomes. Questions 1 and 2 apply the article’s practical interpretation; they are not validated decision rules.

 

Source: Rasmussen et al. (2026), DOI: 10.1186/s12913-026-15764-9, and linked HCPC standards.

References

• Rasmussen, H.M., Løkke, A., Biesenbach, P., Lassen, A., Christensen, A.F., Hoffmann, E., Mikkelsen, S. and Elkjaer, M. (2026) ‘Healthcare professionals’ experiences of implementing paramedic-staffed prehospital assessment units in acute care: a mixed-methods study’, BMC Health Services Research, Article in Press. Accepted 28 September 2026. Read the original paper. Primary source: supplied manuscript.
• Health and Care Professions Council (HCPC) (2023) Standards of proficiency: Paramedics. Effective 1 September 2023. Read the standards (Accessed: 5 October 2026