Calderdale and Huddersfield NHS Foundation Trust NHS Lozenge

First in the country. Paramedics Pete and Steve are trailblazers.

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Two CHFT ED colleagues are amongst the very first paramedics in the country to achieve Independent Prescribers status. Only 50 have achieved the qualification so far.

Steve Dighton and Pete Best both love their jobs meeting colleagues and patients - particularly our elderly patients who say nothing is wrong with them yet have bags of meds! They are also indebted to all the support from colleagues.  Dr Huw Masson, said the dept was "really proud" of their achievements after so much hard work.

So here's more from them.

How long have you worked for us?. Did you have careers before and what were they?

Steve: Coming up to two years. I worked as an ECP (Emergency Care Practioner) for Yorkshire Ambulance prior to this role for 23 years. I also do one clinic a week for Local Care Direct - an out of hours care provider.

Pete:  I was a paramedic with North West Ambulance Service for eight years before joining the trust two years ago as a trainee advanced practitioner. 


How does it feel to have gained the Independent Prescriber qualification and be in the first 50 in the country?

Steve: It's been so long in coming, I did the independent and supplementary Prescribing course 10 years ago whilst doing my MSc, with the view that it wouldn't be long before Paramedics could wrong I was!

Due to the fact that my governing body the HCPC had not agreed to paramedic prescribing until July 2018, I had to do it all again. There are many roles that Advanced Paramedics are going into these days, it's such a relief to finally be able to prescribe in both my current roles.

Pete:  You feel a bit nervous! Always checking indications, contra indications and interactions to avoid harm to patients. A bit of added pressure being one of the first from a paramedic background - you feel like you won’t to make a good name for the profession.

We imagine your ED colleagues have been supportive...

Steve: They have all been truly supportive, Huw Mason my mentor throughout the prescribing course has been inspirational and offered real direction. Janet Youd for having the belief in me and allowing me to pursue this achievement.

The doctors in A&E have never grumbled once at my continual bombardment for Prescription requests, a big thank you to them, special thanks to Naren, he has had to endure the most..... Sorry and thank you.

Pete: All colleagues are supportive. Initially getting through the course with the help of my sign-off mentor and now prescribing and checking appropriateness of a prescribing decision with colleagues

What difference does this qualification mean for our patients?

Steve: I think ultimately that it will offer a more timely consultation, rather than me having to find a prescriber, discuss the case in detail & await their acknowledgement & prescription agreement, I can now avoid this often timely wait.

Pete: This qualification allows the department to run more smoothly and speed up the patient journey. Previously I had to find another clinician to prescribe resulting in delays for my patient and the patient of the prescribing clinician. 

What work is involved in gaining the qualification?

Steve: There have been weekly lectures over a 4 month period. One day spent alongside a NMP (non medical prescriber), one day spent working alongside a pharmacist, key meetings & discussions with my mentor, a numeracy exam where the pass mark is 100%, a 2 hour written essay exam, a portfolio of evidence as well as a 2000 word case based study.

Pete: I have done a level 7 module at university. This was 12 days of lectures over 12 weeks. Testing was by means of exam, essay writing and portfolio. 

Give an example of where you would prescribe where you couldn’t before?

Steve: I'll be able to prescribe in the A&E department on a daily basis in my current role of ACP, & also in my role working for LCD.

Pete: We are expected to independently assess patients and, in more simple cases, independently make a plan for managing the patient. This may involve using medicines. Previously we had to rely on colleagues.  

What do you like about your job?

Steve: There are so many aspects that make my role what it is, the characters that I meet on a daily basis (staff & patient!!), the varying workload, there is rarely a minute of downtime, but I like that, the autonomy of decision making, the variety of service users, every day is a learning day & the amazing team of nurses that are the backbone of many a department.

Pete:  I am learning all the time. I like the interactions with patients, especially some of our older patients with great characters!

Any funny moments?

Steve: Naren's face as I approach him...... He knows what I'm about to ask of him.....I owe you several Costas. 

Pete: It makes me smile when you ask our elderly patients about their past medical history and they say that not much is wrong with them and then you ask about meds and they produce a list.of about 20 different meds.

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