Since the advent of the paramedic profession, its means of educating and training its members has constantly evolved. The transition from predominantly first aid and transport-focused ambulance operations to more specialised services involving increased clinical decision-making has meant the way in which paramedics are trained has had to adapt to meet these accumulating demands. This increase in clinical capability has also led to the realisation that paramedics can, and do, make a fundamental contribution to unscheduled and urgent care.
As a result of this growing interest in the delivery of paramedic education and training, the Allied Health Professional Health Education Advisory Group (formally the Department of Health's AHP Professional Advisory Body) commisioned a study that has called for the introduction of a national education and training framework for paramedics (Allied Health Solutions, 2013).
The Paramedic Evidence Based Project (PEEP), which was funded by the College of Paramedics, emphasises the need for a more robust education and training system. As current education and training for paramedics in England is locally determined, very different levels of learning outcomes are being achieved at the point of registration. It has therefore been highlighted that education and training needs to be standardised, and a clear framework enabling this to happen must be developed.
The report proposes a model that would lead to an all-graduate paramedic profession by 2019. It also proposes raising the minimum threshold entry onto the Paramedic Register of the Health and Care Professions Council, so that all student paramedics enrol on programmes leading to a minimum award for a diploma in higher education (DipHE) by September 2015.
But what would an all-graduate profession offer in contrast to the current model? According to Andy Newton, consultant paramedic and director of clinical operations, South East Coast Ambulance Service NHS Foundation Trust: ‘Education of the workforce is a prerequisite for lasting change and the core enabler for changing clinical behaviour’ (Newton, 2013). Two of the most important areas that would hopefully see significant development as a result of an all-graduate workforce are clinical decision-making and critical thinking. As the report quite rightly points out: ‘If the service is demanding a higher level of competence and performance, and we are demanding that paramedics are more autonomous and have more autonomy to make decisions and to keep patients out of hospital, then we have to develop them accordingly’ (Allied Health Solutions, 2013).
In the evolving pre-hospital care landscape, where increases in population and, as a result, 999 calls, has meant more pressure on A&E departments, the need for a workforce that can reduce hospital admissions by providing clinical care on-scene has never been more important. It appears difficult then to dispute the benefit of enabling paramedic practice to become an all-graduate profession if it will help to make this a possibility.