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Why do paramedics have a high rate of self-referral?

02 May 2018
Volume 10 · Issue 5


Paramedics have been regulated in the UK since 2003. Analysis shows that the profession has had consistently higher rates of self-referral to its regulator compared with other health and care professions. Between 2013 and 2016, the percentage of paramedics who self-referred averaged 50% of all cases, compared with 6% across all other health professions regulated by the Health and Care Professions Council (HCPC) and 10% across social workers in England. This article reports on possible reasons underlying this trend. Using a mixed-methods approach including a literature review, interviews, focus groups and case analysis, the study identified a number of possible contributory factors. These included pressurised work environments, variable guidance and support from employers, and work cultures of fear and conflict. The evolving nature of the profession was also cited. The research found that there was a cohort of cases that appeared inappropriate—where the referral was for a matter that did not require reporting. Actions are being taken to reduce such self-referrals to avoid the emotional distress and resource implications for those involved.

The Health and Care Professions Council (HCPC) is an independent UK-wide regulator of 350 000 individuals from 16 health and care professions including healthcare scientists and allied health professionals. Six per cent of those on the HCPC register are paramedics and in 2014/2015, they made up 10.65% of all fitness-to-practise cases (HCPC, 2015).

Registered professionals are required to refer themselves to the regulator if they believe their behaviour presents a risk of regulatory action being taken against them. The proportion of paramedics who self-refer is high relative to other professions. For example, between 2013 and 2016, self-referrals made up 50% of all paramedic cases, compared with an average of 6% from other health professions and 10% from social workers in England.

There is a general paucity of literature regarding complaints about paramedics and no research specifically on the issue of self-referral in a regulatory context. Most of the literature focuses on issues of professionalisation, and the evolution of a professional identity for paramedics, which may or may not have an influence on self-referral (van der Gaag et al, 2017).

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