‘What's in a name? That which we call a rose, by any other name would smell as sweet,’ as Shakespeare wrote in Romeo and Juliet. In the context in which Shakespeare makes this statement the name is artificial and a meaningless convention, in effect what you are called is insignificant.
However, the Secretary of State for Health, on two occasions when addressing the national press recently referred to paramedics as ‘ambulance drivers’ (BBC, 2016; ITV News, 2016). The role of the ambulance clinician has undergone tremendous growth since the 1990s; the term ‘paramedic’ has now become synonymous with the provision of front-line pre-hospital health care. The Secretary of State for Health has overall financial control and oversight of all NHS delivery and performance, so it is rather worrying that he refers to a group of essential care providers who offer specialist care and treatment to patients who are either acutely ill or injured, can administer a variety of drugs, and carry out selected surgical techniques as ambulance drivers.
The correct use of the title is important for a number of reasons, most importantly for the public who use the services of a paramedic who is registered and regulated by a professional regulatory and statutory body.
There are changes afoot in how health and social care is to be delivered. The Health and Social Care Act 2012 (c.7) has introduced substantial modifications to the way the NHS in England is organised. The introduction of the physician's associate, which incidentally, was originally named the physician's assistant, but changed to reflect their role and their position within the medical team, is a new role. The physician's associate is a healthcare professional who, while not a doctor, works to the medical model, with the attitudes, skills and knowledge base required to deliver holistic care and treatment within the general medical and/or general practice team under defined levels of supervision (Royal College of Physicians, 2016). Health Education England (HEE) (2016) is currently consulting on the introduction of a new nursing role. One element of that consultation concerns the name to be used for this new role. In the Cavendish Review (Cavendish, 2013) into healthcare assistants and support workers in the NHS and social care settings and the Francis Report (The Mid Staffordshire NHS Foundation Trust Public Inquiry, 2013) there was much concern regarding the plethora of titles used and the inconsistency of titles that are used across health and social care sectors.
There has and there remains confusion over different roles, titles, educational preparation and backgrounds of the various roles within the health and social care system. This includes, for example, some misunderstanding about which titles are protected in law. The title registered nurse (as opposed to nurse) is a protected title that has been laid down in the Nurses and Midwives (Parts and Entries in the Register) Order 2004.
‘The correct use of the title is important for a number of reasons, most importantly for the public who use the services of a paramedic who is registered and regulated by a professional regulatory and statutory body’
Paramedic is a protected title by law and misuse of the title could lead to prosecution and a fine. With inconsistency comes confusion for the people using services as well as for those who are delivering services, their role and their responsibilities. For me it is clear that the terminology used should be used correctly, and more importantly, used correctly by the Minister who has responsibility for the oversight of our NHS. A consistent title is necessary to reflect the skills, defined scope of practice and education pathway (HEE, 2016).
While for the star-crossed lovers Romeo and Juliet, Romeo's name did not matter and was indeed an artificial and meaningless convention, for the paramedic profession this may have far wider reaching repercussions. The question has to be asked does Mr Hunt have any other roles, new roles in mind for the profession, as is the case with medicine and nursing, or was his use of ambulance driver a Freudian slip, an aberration of memory or something more sinister? The Secretary of State needs to be made aware of the distaste that some paramedics have regarding his recent blunder.