HSSIB’s latest report highlights the challenges faced by ambulance crews in interpreting ECGs when a patient has a suspected type of heart attack known as an ST Elevation Myocardial Infarction (STEMI).   

The investigation, the second of two exploring the use of 12-lead electrocardiograms (ECGs) in ambulance services, focuses on the equipment and support systems that are used by and assist ambulance crews in diagnosing a STEMI. The findings highlight key issues concerning not only the ECG equipment’s ability to recognise a STEMI, but also the ambulance crews’ recognition and the level of clinical support available to them during interpretation. HSSIB heard from ambulance crews that it was easy to interpret an obvious or “barn door” STEMI from a 12 lead ECG. However, it was more challenging to identify one where patients had less obvious signs and symptoms. 

The report highlights three patient stories illustrating the difficulties of ECG interpretation for ambulance crews. One case involved a 33 year old male who called an ambulance after experiencing chest pain and vomiting. His heartbeat was recorded as faster than usual via an ECG, but a STEMI was not recognised by the ambulance crew and their clinical impression was that it was non-cardiac chest pain due to possible anxiety, his age and other stressors. He was taken to the local emergency department and once he was there a consultant identified that the patient was experiencing a STEMI. The patient went into cardiac arrest and sadly died before he could be transferred to a specialist centre. The Trust incident report noted that if the STEMI had been recognised, the crew could have discussed the patient’s case with the specialist centre team and been taken to the right place for emergency treatment. 

HSSIB identified that the monitor/defibrillator auto interpretation algorithms were not designed to replace clinical decision making by a suitably experienced clinician but may be used by ambulance crews to assist or help confirm the diagnosis of a STEMI. However, the report emphasises that the accuracy of algorithms dropped significantly for ‘borderline’ cases which is when ambulance crews need the most assistance. A review of nine ambulance trust investigations into a missed STEMI showed there was only one incident where the auto-interpretation had stated ‘STEMI’. In the other incidents, the auto-interpretation had stated there was an abnormality of some description. 

When examining the support crews have access to, HSSIB identified risks in relation to further clinical advice and support and communication. Ambulance services have set up clinical support hubs, which were initially to provide advice to newly qualified paramedics. They have evolved to provide advice and second opinions to all ambulance crews. HSSIB’s investigation identified that staff on those clinical advice lines may not have any additional specialist education, training or experience in ECG interpretation. They also couldn’t access all information relating to the patient’s medical history to then provide holistic support to the crews. 

Furthermore, the investigation identified that the specialist centres treating STEMIs (known as primary percutaneous coronary intervention (PPCI)) had limited capacity to provide ECG advice to ambulance crews as they are not commissioned to provide this service. HSSIB’s report highlights that some PPCI centres had implemented two-way communication, to allow for the provision of specialist cardiology advice about suspected STEMI to ambulance crews. This is beneficial for ensuring the patient gets to the right point of care quickly and pressure on surgical teams is also reduced. 

The report makes two recommendations. One is focused on procurement and ambulance trusts assessing devices to make sure the equipment is suited to their needs. The second recommendation is aimed at amending the service specifications for PPCI centres to enable communication with ambulance crews and shared decision making about patients with a suspected STEMI. 

Dave Fassam, Senior Safety Investigator says: “As the patient cases in our report demonstrate, delays in treating a STEMI can cause extensive heart damage and lead to severe harm or death. It is essential that ambulance crews are supported in recognising these emergencies—whether through ECG devices that reflect real-world use or through timely access to expert advice when symptoms are less clear. Our findings and recommendations focus on strengthening these areas to ensure that patients experiencing such a distressing event receive the right treatment, in the right place, at the right time.”

You will have heard the news that we have been granted permission to use the title ‘Royal’.  We now need the approval of you, our members, to apply to the Privy Council for a name change on our Charter, to Royal College of Paramedics.

The approval process will involve a vote, which will open on the 23rd October when full members will receive an email from Civica Electoral Services (CES) containing relevant documents and a link to cast their vote. Voting will close shortly after our Extraordinary General Meeting (EGM), held via Zoom on Thursday 6th November.

Since the granting of our Royal Charter by His Majesty The King in 2024 we have been working towards a legal and financial transfer from the College of Paramedics, company limited by guarantee 05062387 (Registered charity no. 1164445) to the College of Paramedics, Chartered charity 1211180 (Registered company no. RC000940). 

It is this Chartered charity (1211180) that will go by the name Royal College of Paramedics, pending membership and Privy Council approval, and we aim to achieve the legal transfer, with the name change, by 1 January 2026.

We invite you to attend the EGM, which will give you the opportunity to hear from our President, Jon Price and you will be able to cast your vote right up until 15 minutes after the meeting is finished. To register to attend our EGM, click here.

This vital approval is your opportunity to be part of the decision making process to shape the future of your professional body so please look for the email from CES, cast your vote and have your say.

How do I cast my vote?

Full members of the College of Paramedics will receive an email from Civica Electoral Services (CES) on the 23rd October. This email will contain a link to vote as well as the documents you need to help you make your decision. 

If you cannot find the email you should:

1.  Search your inbox for an email from takepart@cesvotes.com with subject: College of Paramedics EGM 2025. Please check your junk/spam folder.

2.  Email support@cesvotes.com to request a reissue, being sure to mention it’s for the College of Paramedics EGM 2025 

3.  Request an automatic reissue via https://secure.cesvotes.com/V3-0-0/contact/forgotcodes.aspx?JMSJobno=m1724_1 – for this process, you will need to enter the email address that we have registered to you in our database

4.  Check that we have the correct email address for you by checking your profile at Member login 

5.  If you are still unable to find an email and believe that you should have received one, please contact penny.jones@collegeofparamedics.co.uk   

Do I need to cast my vote before I attend the EGM? 

No, we encourage members to attend the EGM, and you can cast your vote after hearing from our President, Jon Price, at the EGM. You will still need to use the link in your CES voting email to cast your vote. The vote will close at 13:15 on the 6th November, 15 minutes after the close of the EGM. 

Why vote to approve the name change

Read our FAQs here

The College of Paramedics is proud to share the news that we have been granted permission to use the title ‘Royal’. The College will officially be known as the Royal College of Paramedics from January 2026 after constitutional changes and rebranding have taken place.

This extraordinary accolade recognises the collective efforts of many individual members and the valuable contribution paramedics make every single day to the UK’s healthcare service.

With over 20,000 members, the College of Paramedics is the professional body for all paramedics in the UK: representing their collective voice, shaping the future of the profession and influencing system-wide healthcare delivery at every level.

Since 2000, the role of a paramedic has evolved dramatically, and today, these skilled clinicians are expected to manage a broad range of conditions in the out-of-hospital environment. Paramedics work in a variety of settings including GP surgeries, offshore, higher education, helicopter emergency medical services and the military to name but a few. Whether it’s a role in clinical practice, leadership and management, education or research, the possibilities for a paramedic to develop their full potential have never been greater as the profession continues to grow and develop. 

In 2024, the College of Paramedics was awarded the Royal Charter in recognition of its objectives to inspire and enable all paramedics to participate in the profession within an environment based on safety, collegiality, inclusiveness, mental and physical wellbeing and innovation.

The following year, His Royal Highness The Prince of Wales became the College’s first Royal Patron.

Permission to use the Royal title is granted by The King, acting on the advice of his Ministers. The protected Royal titles are conferred sparingly and, is only given to those applicants which satisfy several strict conditions.

Chief Executive of the College of Paramedics, Tracy Nicholls OBE said: “This historic recognition marks a defining milestone in the life of the College. It is a tribute to the generations of professionals whose commitment, skill, and service have shaped our profession, and it affirms the vital contribution that our members continue to make to society today. This honour also reflects many member surveys where the voice of our members has been evident in the desire to become a Royal College.

“To be entrusted with this distinction is both a privilege and a responsibility. The title Royal not only elevates the standing of our profession, but it also strengthens our voice, enhances our influence, and reinforces our mission to uphold the highest standards of integrity, excellence, and service. It is a legacy we will pass proudly to the generations of paramedics who follow.

“On behalf of the entire membership, I extend our sincere thanks to the Cabinet Office for recognising the value of the paramedic profession in this exceptional way. Most importantly, I wish to thank you, our members, whose dedication has made this moment possible. This honour belongs to each of you, and together we will ensure that we carry it forward with the significance it deserves.

“I believe this is a moment of celebration for our profession and for all those patients we care for in their times of need.”

Jon Price, President of the College of Paramedics said: “It is with immense pride and deep humility that we have been offered the great honour of a change in title with the conferral of ‘Royal’ by His Majesty the King. This historic moment represents far more than a change in name - it signifies the growing recognition of the extraordinary contribution that paramedics make to society. It is a milestone that belongs not only to us today, but to every paramedic who has gone before us and to the future generations still to come.

“This recognition stands as a lasting testament to the courage, compassion, and professionalism that have always defined our profession. It reaffirms the vital role paramedics play in the lives of the people we care for and strengthens our collective commitment to continually advance the highest standards of care. In being offered this honour, we are reminded that the story of our profession is one of service, dedication, and progress — and this moment will echo throughout its history.”

Health policy in the UK is shaped by a complex mix of national and devolved decision-making. While England, Northern Ireland, Scotland, and Wales share a commitment to improving patient care and supporting the health and care workforce, each nation has its own priorities and approach. The College’s policy work covers all 4 Nations, in recent weeks there have been significant developments across the UK with new strategies, workforce planning, and political engagement that will shape the future of healthcare delivery. 

England 

The UK Government has released further details on Neighbourhood Health Services, designed to make access to healthcare easier and closer to home. Roll out of Neighbourhood Health Services is due to begin in September 2025 across 42 of the most deprived areas, with neighbourhood health teams offering diagnostics, rehab, mental health support and more under one roof. 

These plans form part of the NHS 10 Year Health Plan for England, “Fit for the Future”   was unveiled on 3 July 2025, introducing three core shifts: care moving from hospitals to neighbourhoods; digitisation (notably via an upgraded NHS App and AI tools); and a preventive focus targeting public health (e.g. obesity, mental health, smoking). The College of Paramedics shared views and experiences from members to feed into the development of the plan, we will continue to ensure the voice of paramedics are heard as the plan is rolled out.  

Northern Ireland

The Department of Health has begun its workforce review of paramedicine, a key element of the wider programme to support Allied Health Professional (AHP) practice. The College of Paramedics is actively represented on the working group, which will meet every two months and aims to complete its work within 12–18 months. Members will be kept updated on progress, so do keep a look out for updates via our website and our News Digest.  

This work is part of Workforce Planning overseen by the AHP Workforce Review Programme Steering Group, which aims to understand workforce needs, in order to plan effectively to maintain and develop services into the future. 

Scotland

Karen Titchener was appointed as Scotland’s first Patient Safety Commissioner in May, due to take office in September 2025. The commissioner’s role is to advocate for systematic improvement in the safety of health care in Scotland, and promote the importance of the views of patients and other members of the public in relation to the safety of health care.  

The College of Paramedics is a member of the Allied Health Professions Federation Scotland (AHPFS), the group are developing a joint AHP manifesto ahead of the Scottish elections next year. Mandy Powell, Policy & Public Affairs Manager, and Kirsty Lowery-Richardson, Head of Education will be representing the College at a parliamentary engagement event at Holyrood in September, engaging with MSPs. 

Wales 

Our Policy & Public Affairs Manager, Mandy Powell, recently attended a Cardiff meeting of the Sir Charlie Mayfield Keep Britain Working review, highlighting the vital contribution of AHPs and paramedics in keeping people well. Mandy also recently took part in the AHP Dementia Network Wales meeting, which explored ideas to develop the next Dementia Action Plan.  

In June the College and other Allied Health Professions met with the First Minister of Wales and other Ministers in Llandudno to present the joint AHPF Cymru manifesto and take part in roundtable health discussions, promoting understanding of the work of AHPs and paramedics.  

On Wednesday the 25th of June 2025, the topic of adopting a national workforce strategy for Allied Health Professionals in Wales was debated in the Welsh Senedd. The motion was forwarded by Mabon ap Gwynfor, Plaid Cymru Member of the Senedd for Dwyfor Meirionnydd, and called on the Welsh Government to commit to three actions; to adopt a national workforce strategy for AHPs, increase the number of student placements for AHPs, and increase routes to qualifications in Wales to meet growing demand. The campaign to secure a debate came as a result of an effort from the Allied Health Professional Framework Cymru of which the College is a member.  

The debate was a positive one, with Members of the Senedd from a number of parties expressing their support for the motion and agreeing that a national workforce strategy was vital.  

Please contact our policy team for further information or to raise any issues. 
Tom Talyor, Policy Assistant tom.taylor@collegeofparamedics.co.uk  
Mandy Powel, Policy & Public Affairs Manager mandy.powell@collegeofparamedics.co.uk  

PARAMEDIC PROFESSIONAL BODY WARNS GOVERNMENT’S ‘GRADUATE GUARANTEE’ IS DEEPLY CONCERNING AND SHORT-SIGHTED 

Paramedics are facing a serious graduate employment crisis, with up to 40% of 2025 graduates at risk of being unable to find a job. 

These shocking new figures come at a time when the Government has just announced its ‘Graduate Guarantee’ for newly qualified nurses and midwives; a move which has been described as ‘deeply concerning’ and ‘short-sighted’ by the College of Paramedics.

While the College of Paramedics fully supports measures to help newly qualified nurses and midwives into safe, meaningful NHS roles through the Government’s new ‘Graduate Guarantee’ it is unacceptable to design policy for one profession without considering the impact on others. 

Chief Executive of the College of Paramedics, Tracy Nicholls OBE said: “We are deeply concerned that this package has been developed without transparent, cross-professional workforce modelling and without addressing the acute employment pressures facing allied health professions, particularly paramedics.”

The College of Paramedics estimates that 15 to 40 per cent of 2025 paramedic graduates (400 to 1,000 individuals) may be unable to secure a paramedic role on qualification. In the last month alone, over 250 concerned newly qualified paramedics joined a College webinar to share their experiences of struggling to secure employment. The reasons for this looming employment crisis include rapid expansion of pre-registration programmes, recruitment freezes across NHS organisations, reduced post-registration training pathways, and the loss of many roles in primary care following changes to ARRS funding.

Against this backdrop, the Government’s decision to create guaranteed roles for some 
professions risks: 
• Displacing finite funded posts that other workforces, including paramedics, rely on, 
• Worsening competition for limited roles in emergency, urgent care, primary care, and community settings, and 
• Sending a damaging signal that the vital contributions of other clinical professions are somehow less valued. 

Tracy Nicholls added: “This is not merely a workforce planning concern, but it is also a patient safety and system resilience issue. The NHS cannot function without the full breadth of its professional workforces and undermining one to shore up another is short-sighted and counterproductive in our view.”

As such, we are calling on the Department of Health and Social Care to: 
• Pause national roll-out of measures that materially reallocate or convert existing posts until a full cross-profession impact assessment is completed. 
• Publish the workforce modelling and assumptions underpinning the Graduate Guarantee, with regional breakdowns and funding sources. 
• Convene an urgent roundtable with professional bodies, including the College of Paramedics, HEIs, NHS providers, and regulators to assess impacts across all professions. 
• Provide assurance that all posts created are genuinely additional, not achieved by downgrading, freezing, or converting posts used by other professions. 
• Commit to transparent monitoring, with publicly reported data on graduate employment rates, post displacement, service gaps, and patient safety impacts. 

On 1 August 2025, the College of Paramedics held a webinar to hear directly from NQPs about concerns over the current shortage of available roles for graduates. The College has been working with a wide range of external stakeholders to raise awareness of the issue, and feedback from members has been invaluable in shaping the key questions that need to be addressed and enabled us to focus on the most important matters quickly. 

The event also offered practical advice to new registrants, explored alternative employment options, shared examples of best practice, and provided updates on the College’s ongoing work to support those yet to secure a paramedic role.  

This webinar was the first in a series for members, further information will follow shortly.  
We want to reassure our members that we are here to support you during this stressful time.  
Please remember to look at our Mental Health and Wellbeing support for members

The College of Paramedics is calling on all members to engage with the UK Government’s consultation on proposals to extend medicines responsibilities for Allied Health Professions (AHPs). 

The consultation, launched by the Department of Health and Social Care, seeks views on potential changes that could enhance patient care, streamline clinical pathways, and empower healthcare professionals, including paramedics, to use their skills more effectively. 

Chief Executive of the College of Paramedics, Tracy Nicholls OBE FCPara said: “The College of Paramedics has campaigned over many years for these changes, and we welcome the consultation. This is a vital opportunity for paramedics to shape the future of our profession and ensure that our expertise is recognised in the safe, effective, and timely administration of medicines. We strongly encourage every member to review the consultation and submit a response; with your help we can ensure these important changes are made and that paramedics' voices are heard in this important decision-making process.” 

THE CONSULTATION 

The consultation is proposing that paramedics are able to administer the following 7 drugs directly to patients without a prescription under exemptions in schedule 17 of the HMRs within their scope of professional practice: 

3 controlled drugs: 
• lorazepam (by injection) 
• midazolam (by injection) 
• 3 forms of fentanyl (oral transmucosal, intranasal, intravenous)  

4 prescription-only medicines (POMs): 
• dexamethasone 
• magnesium sulfate 
• tranexamic acid 
• Flumazenil

HOW TO RESPOND

Direct link to survey questions 

You will be asked a few questions about your role, and then asked to what extent you agree or disagree with the proposal to enable paramedics to administer each proposed drug. 
There is an option to add comments up to 150 words, it would be helpful if you can use this space to share examples of where you feel the change will benefit patient care. 

Link to consultation for further information 

The consultation is open until 11.59pm 28 October 2025

The College of Paramedics will also be submitting an organisational response but individual submissions from members are essential to demonstrate the strength of support within the profession. 
 
WHY YOUR VOICE MATTERS

· Ensure paramedics’ expertise is reflected in government policy. 
• Support improved patient care through timely access to medicines. 
• Help shape the future scope of paramedic practice. 
  
David Rovardi, MCPara, Specialist Medicines Advisor at the College of Paramedics said: “This is not just a consultation - it is a chance for paramedics to influence change. We need as many members as possible to get involved, share your expertise and be a part of this opportunity for developing the profession to deliver faster patient care.” 

Further information about the consultation can be found here  or you can contact our Policy & Public Affairs team 

Mandy Powell at Mandy.powell@collegeofparamedics.co.uk and 
Tom Taylor at Tom.taylor@collegeofparamedics.co.uk 

National CPD Lead, Gary Strong was given the opportunity to present the College’s Human in Human Factors e-learning as an EMS lab. The ‘lab’ entailed a five minute pitch to the wider Congress, followed by four 30 minute workshops, sharing the learning with EMS personnel from across Europe and beyond. The five minute pitch summarises the purpose of, and rationale, for the project. Watch here.

To access the e-learning, log into your e-Learning for Healthcare account, head to the paramedics programme and click on the module Human Factors and Non-Technical Skills in Paramedic Practice. If you have any access issues please email education@collegeofparamedics.co.uk

Following discussions with the family and funeral director, details can now be shared regarding the guard of honour being planned for the funeral of Matt Capsey. The funeral will take place at 14:30 on 7th August 2025 at Maple Park Crematorium in Thirsk.

Matt Capsey was a friend and mentor to many within the paramedic profession. His kindness, humour, and professionalism will be deeply missed, though the legacy he leaves behind will continue to inspire. The guard of honour aims to reflect that legacy and offer a heartfelt expression of the respect and affection felt towards him.

A passionate advocate for the paramedic as a professional working across a wide range of settings, Matt will be honoured by a route lined with paramedics representing as many different areas of practice as possible. Those participating are asked to wear their usual working dress, appropriate to their role and setting, with the intention of showcasing the diversity Matt championed. While uniforms should be presented smartly, there is no expectation to wear formal or ceremonial attire — paramedics are encouraged simply to be dressed as paramedics. For those not in uniform, light-coloured, respectful clothing is requested rather than traditional black mourning wear.

All are welcome and encouraged to attend, including those outside the paramedic profession. Participants in the guard of honour are asked to arrive at Maple Park Crematorium by 14:00 to ensure everyone is in place ahead of the service. A café on site will be open to those arriving early. To support planning, those wishing to take part are kindly asked to email steven.watkin@nhs.net, though attendance is welcome even without prior notice. The same email can be used for any enquiries.

The UK government has published the 10-Year Health Plan, setting out its ambition to rebuild the NHS in England and bring care closer to home, based around the three shifts of moving from hospital to community, analogue to digital, and sickness to prevention. The College of Paramedics took part in stakeholder events during the development of the plan, sharing the views and experiences of members. As the plan unfolds, we will monitor the impact on our profession.

Click here to read the 10-Year Health Plan

On Wednesday the 25th of June 2025, the topic of adopting a national workforce strategy for Allied Health Professionals in Wales was debated in the Welsh Senedd. The motion was forwarded by Mabon ap Gwynfor, Plaid Cymru Member of the Senedd for Dwyfor Meirionnydd, and called on the Welsh Government to commit to three actions; to adopt a national workforce strategy for AHPs, increase the number of student placements for AHPs, and increase routes to qualifications in Wales to meet growing demand. 

The campaign to secure a debate came as a result of an effort from the Allied Health Professional Framework Cymru of which the College is a member. The AHPF met with ap Gwynfor last year and proposed the idea of a debate on the topic in the Senedd to which he agreed. It comes in light of AHPF Cymru publishing its first manifesto in April 2025, where the first call was for a national workforce strategy for AHPs.  

A link to the manifesto in both English and Welsh can be found here. 

The debate was a positive one, with Members of the Senedd from a number of parties expressing their support for the motion. Labour MS for Cardiff Central Jenny Rathbone said that she was unaware AHPs made up 25% of the workforce in Wales as they don’t get 25% of the attention. They agreed that they are professions that are more than ‘just an addition’ to the health service, and a national workforce strategy was vital. 

Paramedics got mentioned directly twice in the debate by Mabon ap Gwynfor and Cabinet Secretary for Health and Social Care Jeremy Miles. The Health and Social Care Secretary paid tribute to the work paramedics do to keep people out of hospital by being able to refer patients to community falls units or therapy response teams directly, whilst ap Gwynfor praised paramedics for the “immense job” they do in his closing statement. 

The motion passed unanimously, with 47 total votes cast. 31 MSs (across the Welsh Labour Party, Welsh Conservatives, Plaid Cymru, and Independents) voted in favour, there were 16 abstentions, and 0 against.  

MSs agreed that with preventative care being the future in Wales, the professions have to be embedded in policy and leadership at every level from health boards to government. Mabon ap Gwynfor noted at the end of his opening statement that the Welsh Government “can’t not afford to invest in prevention, and we cannot deliver prevention without AHPs”. 

A link to watch the debate in full can be found here: Senedd.tv - Plenary - 25/06/2025. To go straight to the debate, press play on the video, scroll down on the sidebar and click on “Member Debate Under Standing Order 11.21 (iv) – Allied health professionals”.