Funding awarded to improve care for patients with unexpected health findings during ambulance calls

A former paramedic turned academic is playing a central role in a newly funded national project, being led by Yorkshire Ambulance Service NHS Trust, aimed at improving care for patients with previously unknown health conditions discovered during emergency ambulance responses.

Dr Graham McClelland is a Vice-Chancellor’s Research Fellow at Northumbria University, specialising in research into pre-hospital and emergency care, having previously worked for the North East Ambulance Service for 20 years.

He is involved in the new PERIFERAL project (Pathway Enhancement for the Referral of Non-Conveyed Patients with Incidental Findings Encountered by Ambulance Clinicians), which has recently received funding from the National Institute for Health and Care Research (NIHR) and will run over two years starting in October 2025.

Incidental findings – unexpected health issues such as high blood pressure, diabetes, or irregular heart rhythms – are identified in approximately one in six patients during ambulance callouts, often unrelated to the original reason for the 999 call. Many of these conditions are undiagnosed and untreated, posing long-term risks such as stroke or heart disease if not addressed early.

Dr McClelland is a key collaborator on the project and brings significant academic and clinical expertise to the PERIFERAL team, helping shape a research programme that could set a new national standard for how ambulance services respond to incidental health findings.

He explains: “The PERIFERAL project builds on existing work I’ve been involved with here in the North East, working with the British Heart Foundation and North East Ambulance Service. With those projects and this new research our goal is to develop evidence-based referral pathways for patients with incidental findings that can be used across UK ambulance services.  At the moment, there’s a lack of consistency. This work will help ensure that patients get the follow-up care they need to manage or even prevent serious illness.”

The research, led by Dr Caitlin Wilson, Senior Paramedic Research Fellow at Yorkshire Ambulance Service NHS Trust, will examine how different ambulance services currently manage these incidental findings. It will also identify the barriers and facilitators to referral and involve patients directly through a dedicated lived experience panel.

Dr Wilson commented: “I’m delighted that we’ve secured NIHR funding for this important work. Dr McClelland and our wider academic team bring outstanding insight, and together we aim to create a pathway that reduces missed diagnoses and supports public health goals.”

Alongside Northumbria University, collaborators include the University of Sheffield, North East Ambulance Service NHS Foundation Trust, and the Hull York Medical School at the University of York.

The project’s outcomes could have wide-reaching implications for ambulance services across the UK, potentially transforming how paramedics identify, refer, and support patients with undiagnosed chronic conditions encountered during emergency care.