The role of the paramedic practitioner in the UK

Abstract

The 'Paramedic Practitioner' role has developed against a background of change in primary care service provision, apparently resulting in an increasing utilisation of emergency ambulance services. This presents opportunities to extend the scope of practice of paramedics and other health professionals in the diagnosis and management of patients with minor illnesses and injuries. Such patients commonly present via calls to traditional emergency numbers (999) or are referred from other unscheduled care agencies. Paramedic practitioners can reduce the number of patients inappropriately transported to hospital by approximately half, thus meeting an NHS aim of 'treating the right patients in the right place at the right time'. Other opportunities exist in the form of extended roles in critical care and the management of the chronically ill in the community. Currently, a number of pilot programmes exist but vary considerably with respect to type and duration of training, permitted scope of practice, and even the job title of these new practitioners. To be successful, these major changes in the role of ambulance professionals will require the paramedic profession to take leadership through its own professional body (the British Paramedic Association (BPA) in the establishment of defined standards of practice. A shift from vocational training to university-based education will be necessary to meet the intellectual demands of the autonomous management of these patient populations. Uniformity of job title and legal restrictions on its use are also required. These new opportunities for practice will offer a structured clinical career for ambulance professionals for the first time. The BPA has proposed that Emergency Medical Technicians will have a university Certificate; paramedics a university Diploma; paramedic practitioners an Honours Degree; and advanced paramedic practitioners a Masters Degree. Consultant paramedics holding PhDs will support their peers in furthering professional practice. The ambulance profession is coming of age...