On 25 September, the Health and Care Professions Council (HCPC) launched its consultation on the qualification threshold entry level to the register for paramedics—a consultation period that runs until 15 December. Currently, the threshold is set at ‘equivalent to Certificate of Higher Education’ and is the lowest of any registered health profession in the UK. This is a defining moment for the paramedic profession, which has long existed in the shadows of other health vocations.
In 2004, the original Health Professions Council (HPC) Standards of Education and Training were published and the ‘equivalent to certificate level’ demonstrated what was happening within paramedic training at the time, rather than necessarily reflecting the role of the paramedic (HPC, 2004). Most education was occurring in ambulance service training centres instead of at universities, so it is reasonable to argue that anything other than ‘equivalent to certificate level’ would have led to a major recruitment crisis. However, we are 13 years on from that, and the role of the paramedic has changed significantly. Changes to GP contracts in 2008 and the current GP shortage means that paramedics are spending more time managing patients with complex, urgent, and long-term care needs. Decision-making in these environments is often more challenging than in emergency care, as the consequences of leaving the wrong patient at home can be catastrophic for both patient and practitioner. It is difficult to see how this level of cognitive skill can be taught at any level below BSc (Hons) and, arguably, the threshold could even be at masters level.
To exemplify this, it is worth comparing the terminology used in the HCPC (2014) Standards of Proficiency (SOP) for Paramedics with the Quality Assurance Agency (QAA) descriptors in their Frameworks for Higher Education Qualifications. At certificate level, the QAA (2014) states that the student should have demonstrated knowledge of the underlying concepts and principles associated with their area(s) of study, which seems a long way from the HCPC (2014) statement that we should be able to use research, reasoning, and problem-solving skills to determine appropriate actions. This sits more comfortably with the QAA descriptor for academic level 6 (BSc (Hons)) and it is reasonable to suggest that if we expect paramedics to work at BSc (Hons) level, then we should educate them to that level in the first instance.
A move to BSc (Hons) would not only help to provide newly qualified paramedics with the skills and education to do the job, it would improve our professional standing with other health services, prevent another exposé by the BBC Panorama programme as occurred in 2000, and improve public confidence. In my view, it is imperative that the threshold level of qualification adequately reflects what paramedics actually do and this will ultimately lead to improved patient safety.