The
College is pleased to share our first manifesto, which introduces the key
issues we need politicians and decision makers to be aware of and work with us
on to support the profession. With general election due to be held this year,
we’ve worked with colleagues and representatives, including consulting our
Board and Student Council, to develop some keys asks for the next UK
Government.
Our manifesto is an advocacy document predominately aimed at politicians, as
well as listing key issues for the paramedic profession, it explains the roles
and skills of paramedics. We have sent it to all the main political parties as
part of our policy and public affairs engagement work.
You can read the full manifesto here or in full, below. As we
get closer to the general election we will share more resources with our
members, including a guide to contacting your local representative and
summaries of the party manifestoes.
The manifesto is part of our ongoing policy and public affairs work with
governments and stakeholders across the UK, making sure the profession is
represented and our members have a strong voice, we will keep members informed
and involved with our work, including our progress on the development of an All
Party Parliamentary Group on Paramedicine.
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College of Paramedics
Manifesto 2024
Introduction to the paramedic
profession
Paramedics are registered
healthcare professionals who work across a range of emergency and non-emergency
situations, using judgment and skills to quickly access a patient’s condition
and make life saving decisions. The profession may be most well-known for
working within ambulance services providing immediate and emergency care in
response to 999 calls made by the public, however paramedics also work in other
areas of healthcare, including:
- Accident and emergency departments
- Clinical speciality – e.g. stroke
- Cruise ships
- Custody
- Education
- Expert witness
- General practice
- ICU
- Leadership roles
- Same Day Emergency Care (SDEC)
- The military
- Neurosurgery
- Primary care
- Urgent care
- Public health, including frailty
- Remote and offshore sectors
- Research
- Rural and remote medicine
- Telehealth and telecare services
- Hospice, Palliative and End of life care
Since 2021, paramedics are regulated by the Health and Care Professions
Council (HCPC) and must have completed a HCPC approved programme and be
educated to degree level. HCPC sets standards for professional education,
training, and practice, and is responsible for taking action if a professional
on the register does not meet the required standards.
- The title ‘paramedic’ is protected in law, and all paramedics must be
registered with the HCPC to be able to practice.
- There are currently over 30,000 paramedics on the HCPC register, and this
encompasses all paramedics, regardless of where they work.
How paramedics make a difference
Over the last decade, evolutions
of the emergency ambulance service from an ‘assessment and transport’ model to
a ‘see and treat’ service have resulted in the development of the paramedic
profession.
- Paramedics continue to respond to a range of undifferentiated and
undiagnosed patient groups in their own living environments.
- Regardless of where they work, paramedics undertake comprehensive clinical
assessments, and can take the responsibility for the ongoing care provided to
patients, in addition to onward referral and discharge.
- Paramedics are also eligible to undertake further
study to work as independent prescribers, enabling them to complete full
episodes of patient care.
- The adaptability, creativity and problem-solving skills of paramedics means
they are well placed to support community-based care, working in collaboration
with other health professionals to provide patient care and support closer to
home.
- Paramedics also have a role to play in prevention and public health, due
to their unique position of providing unscheduled care in the patient’s own
environment and the ability to reach populations who may not access NHS
services and public health information in a traditional way.
The important role paramedics play in supporting future health needs has been
recognised in the recently published NHS Long Term Workforce plan for England.
“Our assessment is that the
paramedic workforce will need to increase by around 14,200 – 15,600 over 15
years, to deliver services in ambulance and other care settings, as well as
creating a pipeline of staff who will go on to work as advanced practitioners.
To enable this, the Plan proposes that paramedics have more rotational training
placements across hospital, community, and primary care settings.”
As the current health and social care systems are
under enormous pressure, paramedics have a key role to play in ensuring patient
healthcare needs are met by autonomous, well-educated, registered
professionals. It is for this reason that it is vital to address the issues of
recruitment and retention to ensure the profession can continue to deliver
high-quality patient care.
We urge all political parties to
commit to the following recommendations:
1 - Parity for paramedics
across the UK
Health is a devolved matter, we
call on all parties and Governments to work together to ensure the skills of
paramedics are recognised and supported equally across the UK, so that
paramedics can apply their full range of skills and knowledge wherever they are
based to best meet patient needs.
2 - Improved data sharing
to aid learning and development
Access to patient records has
improved in recent years, but more needs to be done to enable paramedics to
have timely access to patient data to ensure continuity of care, as well as
including feedback on patient outcomes to support professional learning and
development.
Currently there is no consistent process for paramedics working in emergency
care to receive feedback on patients once they have been admitted to hospital,
often preventing learning from taking place. Paramedics working in all
settings, including primary care and prevention should have consistent access
to patient records to ensure minimal delays for patients to access care.
3 - Impactful investment in
mental health and wellbeing support for frontline and high intensity clinical
settings
Paramedics are usually the first clinical healthcare professionals to reach
patients experiencing medical emergencies and traumatic injuries, often within
some of society's most challenging, unpredictable, and violent environments.
The unprecedented rise in demand for emergency and urgent healthcare services
across the year has added greater pressures upon the system even prior to the
winter season.
Working at high intensity for long periods of time has a negative impact on all
healthcare staff including paramedics and ambulance personnel. Paramedics are
reported as having one of the highest levels of suicide of all the healthcare
professions, and one of the highest levels of sickness absence attributable to
poor mental health including burnout, stress, depression, and post-traumatic
stress.
We call on decision makers to invest in long-term mental health and wellbeing
support for staff in the health and care sector, especially those such as
paramedics working in high stress situations, to ensure they are well supported
and are able to provide quality care to patients. We therefore, call on the
Government to continue to fund the vital support provided to NHS staff through
the NHS staff mental health and wellbeing hubs.
4 - Expansion of prescribing rights for
paramedic independent prescribers
Following a lengthy campaign from the College of Paramedics, the Home Office
recently updated legislation to allow paramedic independent prescribers to
prescribe a list of controlled drugs. The changes allow for the timely, safe,
and effective supply and administration of medicines to patients. It also
presents the opportunity for paramedics to support patients with de-prescribing
in line with NICE guidance on medicines associated with dependence or
withdrawal symptoms: safe prescribing and withdrawal management for adults.
There are currently over 2117 paramedic independent prescribers in the UK, all
of whom have completed an approved prescribing programme, and who work across a
variety of settings including primary care, palliative care, specialist wards
and critical care.
More needs to be done to expand the ability for paramedics to prescribe a full
formulary of controlled drugs to fully provide patients with the care and
treatment they deserve, including an amendment to the Human Medicines
Regulations to allow student paramedics the right to administer injectable
medication under schedule 17 exemption to support development of practice-based
learning. This will be a longer-term consultation but will require the
political will for the profession to release the burden on our other health and
medical colleagues within a safe and well-governed framework.
5 - The role of paramedics in hospital
handover and patient flow
The Emergency and Urgent Care system faces huge challenges, with delays in
ambulance to emergency department patient handover. This has a detrimental
impact on patients and the professionals who care for them. Undifferentiated
patients awaiting ambulance response in the community presents the greatest
patient safety risk during times of increased pressure.
The College of Paramedics works alongside our healthcare colleagues to press
for change. We call on decision makers to work with us to address the challenges
and support the ambulance sectors capacity to deliver a safe and effective
service to those in the most need.
6 - Support investment in professional growth
In order to ensure a continuous stream of new professionals, Higher
Education Institutions (HEIs) need support with funding for undergraduate
courses, and support for the recruitment and retention of paramedic educators
who work in both clinical practice and education.
7 - Appropriate funding for resources to meet
demand within UEC (Urgent & Emergency Care)
The College would support a full commissioning review to enable a modern
provision of care to better meet the needs of the patients. Future service
provision by paramedics may not always emanate from within the ambulance
sector, but by a wide and diverse range of options, and a new commissioning
model could provide greater benefit to patients by looking at a whole patient
journey through the health and care system, rather than just a single touch
point.
With much more focus on urgent care through the 999 system, it provides a real
opportunity for commissioning to be fit for the future.
8 - Support integrated
community care to reduce avoidable conveyance to hospital
Paramedics work autonomously with undifferentiated and undiagnosed
presentations. It is this pluripotential nature that can be used to support
integrated community care and reduce further admission to hospital for patients
where this is avoidable.
It must be recognised that not all paramedics work in the ambulance sector and
many paramedics have been able to specialise in clinical areas that will
support the recovery of emergency and urgent care, such a frailty, end of life
care, mental health, maternity, and public health.
Paramedics are uniquely placed to work in these areas, with a
range of other allied health professionals, nurses, and social prescribers, to
care for high-risk patients in the community who have been discharged, or to
attend low-risk patients who they may be able to prevent requiring admission.
9 - Greater definition and
support of Advanced Practice roles
Supporting advanced practice
helps other services, such as freeing up emergency ambulances to answer the
most life-threatening calls.
Greater clarity of the scope of
roles will also support the development and diversification of paramedics as
healthcare professionals in their different work environments, and supports the
nomenclature to be understood by not just other medics and healthcare
professionals, but by patients and their relatives and carers.
About Us
The College of Paramedics is the recognised
professional body for paramedics and the ambulance professions. We support the
profession by providing leadership and advice to our members, and to people
considering joining the ambulance professions.
The College of Paramedics will continue to be the pinnacle of information and
advice for the paramedic profession. We will continue our work with our members
and colleagues to be the centre of paramedic-focused issues, including
educational standards, professional standards and practice, leading research
and developing guidelines for paramedic practice in any environment.
We are committed to support the development of paramedics, using the four
pillars of the profession to guide our work:
- Clinical Practice
- Leadership & Management
- Education
- Research & Development
We welcome opportunities to discuss these issues further.