February marked the first time that paramedics were recommended for addition to the shortage occupation list (SOL), with vacancy rates running at approximately 10% of the total 12 500 paramedic workforce in England (Migratory Advisory Committee, 2015).
Using evidence received from the Centre for Workforce Intelligence, the Migratory Advisory Committee have identified a number of factors driving the shortage. These include: significant increases in demand for ambulances as a result of the shift in focus to treat people at home rather than in A&E; high staff attrition due to work pressures and stress brought on by longer working hours; and growing opportunities for paramedics to take on roles in alternative areas such as the 111 service, GP practices and walk-in centres.
In an attempt to combat the shortage, ambulance services have been forced to introduce a number of initiatives. Many have looked overseas to fill the gap in the workforce, as retraining a healthcare professional to meet Health and Care Professions Council (HCPC) standards usually only requires a short conversion course. This is particularly true for countries such as Australia and New Zealand, where the skills and training are similar to the UK. While only one paramedic was recruited from overseas from 2013–2014, 183 have already been recruited from 2014–2015, with further recruitment planned (Renaud-Komiya and Calkin, 2015). However, it is worth noting that the migration of healthcare workers brings with it ethical issues, as services abroad may suffer as a result of their own falling numbers (Peate, 2014).
Increasing the number of student paramedics will help to secure future generations of the workforce; however, it does not tackle the problem now, and does not help deter those paramedics who are already considering leaving the profession. Not only this, but higher education institutions (HEIs) are limited by the number of places they can offer. The shift of training in 2009 from in-house ambulance service training to a mix of degree, diploma, and foundation degree courses, has had a considerable impact on the profession. What is really needed, therefore, is a national funding scheme for the training of paramedics (Barnes, 2015). If national investment was made in paramedics then HEIs would be able to take in bigger cohorts as more places would be funded. Health Education England (HEE) has pledged to increase the number of paramedic training places by 87% over the next two years, but these additional commissions will not produce qualified paramedics until 2016/17 (HEE, 2015). Growth to the paramedic workforce is essential; however, the rapid level of increased demand from ambulance services means that shorter term supply solutions must be found if growing vacancy rates are not to deteriorate further until this newly trained supply becomes available.