PERIFERAL
Research type
Research Study
Full title
Pathway enhancement for the referral of non-conveyed patients with incidental findings encountered by ambulance clinicians
IRAS ID
348609
Contact name
Caitlin Wilson
Contact email
Sponsor organisation
Yorkshire Ambulance Service NHS Trust
Clinicaltrials.gov Identifier
64463, CPMS ID; https://bit.ly/CReD-PERIFERAL, College of Paramedics' Research Database
Duration of Study in the UK
1 years, 11 months, 30 days
Research summary
Background:
When ambulance crews go out to emergencies, unexpected health problems are found in 1 in 6 patients. These problems are not related to the emergency that the ambulance was called for and are called "incidental findings". These might include an irregular heartbeat, raised sugar levels in the blood or high blood pressure. Patients may not have noticed any of these symptoms, but leaving them untreated could cause other health problems. People from disadvantaged backgrounds are more often found to have these unexpected health problems. Finding and treating unexpected health problems early helps people to prevent serious illnesses, like diabetes, strokes and heart attacks.
Ambulance crews across the UK deal with incidental findings differently. Some take patients to the emergency department, others recommend that patients see their GP - but we do not know if patients follow this advice.
Aim:
The PERIFERAL project aims to improve care for patients with incidental findings.
We intend to:
• Describe the patients that have incidental findings and what happens to them.
• Report how UK ambulance services deal with incidental findings.
• Identify what aspects of current processes work (and what does not) for staff and patients.
• Use what we have learned to improve the management of incidental findings and talk to patients, carers, ambulance and GP staff to see whether they agree with our ideas.
Design and Methods:
Our study has four steps:
1. Understanding what happens now: We will analyse data from Yorkshire Ambulance Service and GP practices. We will see what happens when ambulance crews find incidental findings, how often they share this with GPs and whether it makes the ambulance visit any longer.
2. Comparing approaches: We will explore how other UK ambulance services deal with incidental findings.
3. Identifying what is likely to work: We will interview 40–60 patients, carers, ambulance staff and GPs across four ambulance services. We will ask them what ways of managing incidental findings are likely to work well, and what may cause problems.
4. Develop a new way of managing incidental findings: We will use what we learn to design better way sof managing incidental findings. We will present our ideas to 32 people in a focus group for their feedback.
Patient and Public Involvement:
People with experience of ambulance call outs are included in the project patient panel. Some have diabetes, heart problems or experienced a stroke. We have also asked existing patient panels for input. The project panel and existing patient panels will help to revise research materials, shape ideas and share results.
Dissemination:
We will share our new referral pathway and other findings in easy-to-understand formats with the people who take part in the study. We will share findings widely using our website, peer-reviewed publications, reports and presentations to healthcare professionals, researchers and the public.REC name
East of England - Cambridge East Research Ethics Committee
REC reference
26/EE/0050
Date of REC Opinion
20 Mar 2026
REC opinion
Further Information Favourable Opinion