A day in the life of Community Specialist Paramedic, Sara Harris Waving goodbye to 108 year old Lilian as she left Trafford to start her new life in Wales, the role of a community specialist paramedic like Sara Harris is like no other in North West Ambulance Service. Lilian is one of a number of patients who Sara visits regularly in her local community to provide support for patients’ health and care needs and prevent 999 calls for minor ailments. Sara is one of 10 paramedics who work more closely with the communities in which they are based. The idea is that Sara’s central presence in the Trafford community enables a more patient-centred approach to healthcare in a way that the ambulance service wasn’t able to provide before community specialist paramedics were introduced in 2015. Working with GP practices and alongside other healthcare professionals who support local residents, Sara’s responsibilities are to develop and promote alternative treatment pathways, engage with local nursing and residential homes and educate local school children. A routine day for Sara started with a visit to Lilian to say an emotional goodbye and check she was fit to travel to her new home after spending all of her life in Trafford. A quick Google search reveals Lilian is the 37th eldest person in the country! She has four letters from The Queen that have been packed up along with her treasured possessions ahead of the move. Ambulance crew Nigel and Gareth helped to get Lilian down the stairs safely The next stop was to a person known to North West Ambulance Service as a frequent caller – someone who calls 999 four or more times in a month or 12 times in three months. Sara called in to check how the patient, a recovering alcoholic, was coping. There are around 55 frequent callers in Trafford and Sara’s involvement enhances the support offered by the NWAS Frequent caller team by helping them to access other services they might need in order to reduce the number of times they call 999. Sara expressed admiration for the work this team does for this group of often very vulnerable patients. Sara receives referrals from other ambulance crews who believe she may be able to support patients they have seen. One of these people had heart failure; a condition which leaves patients breathless, feeling tired and with swollen ankles and legs, another referral was for someone who had fallen at home. Sara called in to see a lonely patient who compared their daily routine with “watching paint dry”. This patient’s complex needs, as a result of a stroke which dramatically changed their life, required a tailored care plan which details who is involved caring for them and gives helpful care information to ambulance crews who may be called in the future. On both occasions Sara was able to link the patients in with the Trafford Co-ordination Centre; an excellent service which harmonises access to health and social care services for people who are frail, have had a fall, or who are vulnerable so they can stay safe and well at home. The final routine visit was to a 90-something-year-old with dementia and lived alone with no family support, despite the gallery of nostalgic family photos on the wall. Sara made notes to share with the patient’s doctor when she realised he hadn’t taken up to three weeks’ worth of medication. Before the day came to a close, ambulance control asked Sara to attend a patient who had called 999 with abdominal pain. She was able to request non-emergency transport to take the patient to hospital, keeping the finite number of ambulances in the area free for patients with life-threatening conditions. 40% of Sara’s time is spent responding to emergencies in the area to keep her clinical skills up to date and provide care for emergency patients. Talking about her role, Sara said: “In the ambulance service we don’t usually find out what’s happened to the people we care for. The great thing about my role is that I get to go back and check on patients and can continue to help them to get what they need from the health service. “I deal with some of the most vulnerable people in our community and being there for them regularly, as a familiar and friendly face, encourages them to trust in me to help, gives me the opportunity to educate them about using services in the right way and signpost them to support in the area that they would benefit from. “As a country we could care so much better for our elderly population, but there are some wonderful services in Trafford that I can refer people into or make people aware of - that’s the benefit of being committed to a particular community. “I thoroughly enjoy my role and the difference I can make to people’s lives by working in collaboration with health and care services in the area. I feel that by working together we can achieve so much more for patients rather than in isolation as one organisation.” Sara has spent 17 years working in the ambulance service and currently working towards an MSc in Advanced Clinical Practice at Manchester Metropolitan University.