The Four Pillars: outlining and aligning our future

Paramedic practice has developed substantially since its inception in 1971 and the last 55 years has seen professional registration for paramedics, as well as progression from vocational to academic entry to the profession (College of Paramedics, 2015). This has coincided with a vast enhancement in the clinical care we provide, and is largely in conjunction with a transformed health service model (Department of Health (DH), 2005), and widespread socio-cultural dependence on the ambulance service (NHS England, 2015).

Since the Journal of Paramedic Practice (JPP) was established nearly a decade ago, paramedic practice has progressed still further, with degree-level entry for paramedics to the register, and prescribing for advanced paramedics on the horizon.

The UK professional body, the College of Paramedics, has adopted the ‘Four Pillars of Practice’ from NHS Wales (National Leadership and Innovation Agency for Healthcare, 2010) into its postgraduate career framework (College of Paramedics, 2014). These pillars are designed to guide clinicians who wish to advance their careers following professional registration. Individual practitioners can combine activity within each pillar and the level of activity will be dependent on the specific elements of the Skills for Health (2010) Career Framework. Since these pillars mark the underpinning themes for professional practice, we have decided as a journal to adopt these themes as core sections within each issue.