College of Paramedics’ Position Statement on the designation of paramedics: Undertaking Extended Scope of Practice

The clinical concept of operation for the UK ambulance service is changing radically and evolving at an increasing pace with greater emphasis upon clinical treatment rather than the historical transport function. This trend, which started accelerating from the 1970s when the first paramedics (then termed ‘extended trained ambulance staff’) were developed, has followed a course of expanding the clinical capability of ambulance professionals.

In essence, this means a fundamental change in priorities with patient assessment, treatment and, where necessary, appropriate referral are becoming more common, with less demand for transport.

The clinical ramifications of these changes are substantial, both operationally and in regard to professional issues for paramedics, upon whom a range of increasing responsibilities fall. This evolution in role has been led by rising patient demand and reconfigurations within the wider NHS, particularly those that have affected general practice, including the amendments in the contractual obligations of GPs.

These changes have taken place against a background of escalating 999 call volumes which have increased from approximately one million in 1966 to nearly eight million today, with a massive increase in the order of 100% occurring between 1996 (3.2 million) and 2006.