If you’re out and about in Merton, keep your eyes peeled for Matt Kilner, the paramedic on a bike.
Working with the South West Merton Primary Care Network (PCN) since October 2020, Matt’s brief as a trainee first contact practitioner is to work with GPs as part of teams providing same-day care. The PCN brings together the Nelson Medical Practice and Grand Drive Surgery, Raynes Park. If an urgent call comes in that can’t be dealt with by GPs on the phone, he zips out to appointments and does a home assessment and then reports quickly back to the centre.
“Paramedics have the knowledge and experience of treating people in their home environment,” says Matt. “We take a holistic view of how people live and because we spend a lot of time in home environments we can pick up on issues such as self-neglect, even if the signs are subtle”.
“Unlike many hard-pressed GPs we have more time to spend with patients. We can spend 45 minutes or longer with patients to find out what really matters to them and help build their personalised care plans.”
Trusted and friendly figure
One such patient was Rose* who had had very little contact with the surgery over the years and had always been very ‘anti-medicine’, according to Matt. Through a series of visits, prompted by Rose’s family, Matt became a trusted and friendly figure with whom who she felt comfortable speaking.
A couple of months ago, Rose became poorly and needed to engage in some simple tests to identify the best course of treatment for her. “In the past, Rose would have shut down and become cold and defensive and adamantly refused any interventions. Without these she could easily have deteriorated.” Matt says. “These interventions really wouldn’t have been possible without building a personalised care approach and finding out what really matters to her.”
Matt’s ability to provide a rapid response to patients can sometimes literally be a life saver. When Terry* – a housebound patient – called the Nelson with an apparent infection – he would normally have been placed on a home visit list for lunchtime or afternoon.
“As a paramedic, I don’t have specified clinics or appointments and so am able to triage the most urgent calls and see those first. In Terry’s case, I was able to visit hours before a doctor would have been able to which potentially saved his life as he was showing signs of sepsis and I was able to arrange a 999 response for emergency treatment. “
Matt is jointly employed by the PCN and the London Ambulance Service (LAS) Cycle Response Service at New Malden. On quieter days for home visits at the two GP practices, when he is not working with same-day teams, he will make routine visits to patients for diabetic or dementia reviews and leads an elderly frail, low-contact project.
The Paramedic/primary care project developed from a six month trial organised by LAS and all of Merton’s 6 Primary Care Networks, organised by the borough’s GP Federation Merton Health, after the announcement by Health Education England that paramedics were going to be one of the new multi-disciplinary roles introduced. “The aim of the project was to look at what emergency paramedics could offer to primary care. At the time, primary care providers hadn’t really realised the skills and levels of responsibility that paramedics could bring.”
“When people first see a paramedic arrive at their door they are usually quite surprised, but comforted because traditionally it is a profession they feel they can trust. Being treated in your home is reassuring to people and helps to ensure that their thoughts and feelings are valued.”
Matt points out that there are still some visits that only a GP will be able to perform. With most busy GPs only able to fit in a couple of home visits each day, Matt’s extra eight visits a day mean many more people in Merton are able to benefit from care in their home.
Formerly working in investment banking, Matt’s change of career also has the added benefit of keeping him super fit and promotes a healthy lifestyle. “Being on a bike is also very good from an environmental point of view,” he says.
*Names have been changed