Published by the Department of Health and Social Care (DHSC) in 2005 (then the Department of Health), Taking Healthcare to the Patient identified a number of ways in which the transformation of ambulance services in England could improve patient care.
Increased autonomy
The report recommended that, rather than always conveying to hospital, paramedics should be able to assess, treat and, if necessary, decide on the appropriate care pathway for the patient. This included being able to treat, provide advice to patients on self-care, and signpost or refer to primary or secondary services.
Education and training
The report went on to state that education and training for paramedics needed to focus on the diagnostic and clinical reasoning skills needed to deliver this type of care. Specifically, it highlighted the need for knowledge and skills in physical assessment, clinical decision-making, long-term conditions, minor illness and injury.
In 2013, Health Education England (HEE) published the Paramedic Evidence Based Education Project report. Commissioned by the DHSC and funded by the College of Paramedics, the report recommended that the paramedic profession should move towards becoming an all-degree workforce.
The need for parity with the other allied health professions and the benefits of a graduate workforce for patient outcomes were cited as reasons for the change. This was in addition to ensuring paramedics have the sufficient clinical decision-making skills needed to manage the ‘complex case mix’ now required of them.
Degree-level entry
In 2017, the Health and Care Professions Council (HCPC) consulted on changing the threshold of qualification for entry to the Register for paramedics to degree level. This proposal was approved by the HCPC Council in March 2018.
As well as equipping paramedics to make independent, complex decisions, becoming an all-degree profession reflects the needs of contemporary paramedic practice. It also future-proofs the profession, giving paramedics greater opportunity to take on more advanced skills and roles, and better reflect the advances the profession has made over recent years.
Independent prescribing
As of 1 April 2018, paramedics have been able to undertake training in independent and supplementary prescribing. Looking ahead, paramedics who undertake and successfully complete an approved prescribing programme will have their HCPC registration annotated to record their ability to practice as a prescriber.
This will enable paramedics to prescribe medicines for their patients immediately and without the need for a GP consultation. It also means that paramedics who work in accident and emergency (A&E) departments will be able to prescribe medicines.
Extended scopes
The number of approved paramedic programmes over the last 7 years has also been on the rise, going from 56 in 2010–11, to 76 in 2016–17. Extending their scope of practice in a way which supports positive patient outcomes is another significant step in the evolution of the role of a paramedics.