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Towards a person-centred holistic consultation framework for paramedics attending non-acute presentations: A multidisciplinary commentary

King, Robbie
Martin, Angela
Batt, Alan M.
Martin, Sonia Louise
Barr, Nigel
Hwang, Caroline
Lord, Bill
O'Meara, Peter
Reynolds, Louise
Hammarbäck, Staffan
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Abstract
Introduction: Traditional rapid-assessment models may not be fully suited for the complex non-acute presentations that paramedics commonly encounter. As paramedicine evolves to meet non-acute patient needs, extended practice community paramedic roles are emerging to deliver holistic and collaborative community-based healthcare. Purpose: This commentary outlines the need for a person-centred holistic clinical consultation framework for paramedics attending complex non-acute presentations. A framework that provides a structured and systematic process for paramedics, particularly those who are transitioning into extended practice community paramedic roles, to guide them in conducting holistic person-centred assessments. This commentary highlights the importance of understanding the biopsychosocial factors influencing patient wellbeing and provides a conceptual foundational framework as an example for the paramedicine community to further develop and validate. Relevance: A standardised systematic consultation approach supports more effective communication, shared decision-making, and safe care planning. Such a framework aligns with professional standards to enhance interprofessional collaboration and improve health literacy and equity for structurally marginalised patients. Outcome: We propose a nine-phase clinical consultation framework for non-acute presentations to improve accuracy in clinical reasoning, paramedic confidence, and patient outcomes. Through patient engagement, trust-building, and addressing impacts of the social determinants of health, this framework aims to refine paramedic practice for complex non-acute presentations and support integrated care models. Conclusion: The proposed patient consultation framework aims to guide paramedics toward a structured, comprehensive approach for assessing non-acute presentations bridging the gap between rapid emergency-focused assessment and community-based care for complex and often undifferentiated non-acute presentations. As paramedics develop confidence in exploring each patient's individual biopsychosocial circumstances, they will be better positioned to enhance patient experiences and outcomes, further contributing meaningfully to their continuum of care.
Keywords
community paramedic, extended practice paramedic, ambulance, framework, consultation, assessment, paramedic, integrated care
Date
2025
Type
Journal article
Journal
Paramedicine
Book
Volume
Issue
Page Range
1-12
Article Number
ACU Department
School of Nursing, Midwifery and Paramedicine
Faculty of Health Sciences
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC 4.0
File Access
Open
Notes
© The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).