Passing the mantle: a parting farewell

Adobe SparkThis issue of the Journal of Paramedic Practice will be my last as editor. It has been an honour and privilege to edit a publication aimed at one of the most exciting healthcare professions, and I am grateful for being given this fantastic opportunity. I took over the journal in 2013, having previously worked on a nursing title, and in those few short years have witnessed a notable change within the paramedic profession.

The publication of the Francis report marked the beginning of my time as editor, and although not directly concerned with paramedics, it highlighted a need for cultural change within the NHS, with an emphasis on patient-focused care. This was followed by the long overdue update to the UK Ambulance Services Clinical Practice Guidelines, which was welcomed by the profession. The latest update was published earlier this year.

The publication of the end of study report for the Paramedic Evidence Based Project (PEEP), which called for the introduction of a national education and training framework for paramedics, marked a turning point for the profession and highlighted how its needs were changing. This was cemented in Sir Bruce Keogh’s Urgent and Emergency Care Review, which called for the development of 999 ambulance services so that they become mobile urgent treatment services. Illustrating an appreciation of the skill set of paramedics, their potential in the delivery of pre-hospital care was finally being recognised.

The Five Year Forward View expanded on these ideas and proposed a broadened role for ambulance services. It was becoming apparent that out-of-hospital care was becoming an increasingly important part of the work the NHS undertakes.

One of the most significant changes within the profession over the last few years has been the growth of its professional body. As of January 2016 there were 6 458 full members of the College of Paramedics. This represents 29.7% of all paramedic registrants of the Health and Care Professions Council, the regulatory body for the paramedic profession. The increase in members show the College is one step closer to its aim of becoming a Royal College, which requires that 50% of the profession are members of the professional body.

However, this evolution has not been without its difficulties. Reports of staff facing burnout, time taken off work due to stress-related illnesses, problems with staff retention, disputes over pay, and the fundamental problem of how ambulance services can cope with year-on-year increases in demand, mean the workforce is facing all manner of pressures.

Despite this, I believe these are exciting times for paramedics. As we gradually see a move to an all-graduate profession and changes to the paramedic scope of practice, the opportunities for work outside of the ambulance service are growing.

As I pass the mantle, I look forward to seeing the journal reach new heights following my departure under a new editor. It only remains for me to personally thank my consultant editors, the editorial board, and of course, you the readers, who have ensured the publication could continue.

Taken from Journal of Paramedic Practice, published 5 August 2016.

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2013: the year in review

As paramedics across the country are recovering from the busiest shift of the year, the Journal of Paramedic Practice thought it would look back over 2013 and consider some of the notable events that occurred, both good and bad.

The beginning of 2013 will be remembered by most for the tragic loss of Roland Furber, President of the College of Paramedics, who passed away on 4 February. Roland and his late wife Carol were known for the huge contribution they made to the paramedic profession and the establishment of the professional body, which was then the British Paramedic Association (BPA). As the inaugural chief executive of the BPA, Roland made an enormous impact on the founding of the profession.

February also saw the release of the final report of the Mid Staffordshire NHS Foundation Trust Inquiry chaired by Robert Francis QC, which though not directly affecting paramedics, raised a number of important questions concerning the care of those who are older and more vulnerable. Perhaps more than anything it highlighted the need for a cultural change within the NHS, where patients are placed at the centre.

One of the most notable events of the past year was the long-awaited publication of the UK Ambulance Services Clinical Practice Guidelines 2013, which was issued following lengthy development with JRCALC and National Ambulance Service Medical Directors. The first major re-write since 2006, it features a number of significant changes in terms of guidance for clinical care. Work is already underway scoping future editions and updates, as can be seen in the obstetrics and gynaecology update published in this issue.

April saw the new health and care system in England become fully operational, with its ambitious aims to deliver the content laid out in the Health and Social Care Act 2012.

August saw the publication of the end of study report for the Paramedic Evidence Based Project (PEEP). Commissioned as a result of the growing interest in the delivery of paramedic education and training, the project called for the introduction of a national education and training framework for paramedics.

Perhaps the biggest piece of news came with Sir Bruce Keogh’s report on the first stage of his review into urgent and emergency care, published 13 November, which presented a significant step in the progression of the paramedic profession. Sir Bruce’s call for the development of 999 ambulance services so that they become mobile urgent treatment services, illustrated an appreciation of the skillset of paramedics and their potential in the delivery of pre-hospital care.

Finally, 2013 marked the five-year anniversary of the Journal of Paramedic Practice, which was launched in October 2008. On behalf of the journal I would like to thank the editorial board, the consultant editors, all those who have contributed to the journal, helping to make it an informative learning resource, and most of all, you the readers, without which this publication would not be possible. I look forward to another exciting year and wish you all the best for 2014.

Taken from Journal of Paramedic Practice, published 10 January 2014.

The future of training and education

Since the advent of the paramedic profession, its means of educating and training its members has constantly evolved. The transition from predominantly first aid and transport-focused ambulance operations to more specialised services involving increased clinical decision-making has meant the way in which paramedics are trained has had to adapt to meet these accumulating demands. This increase in clinical capability has also led to the realisation that paramedics can, and do, make a fundamental contribution to unscheduled and urgent care.

As a result of this growing interest in the delivery of paramedic education and training, the Allied Health Professional Health Education Advisory Group (formally the Department of Health’s AHP Professional Advisory Body) commisioned a study that has called for the introduction of a national education and training framework for paramedics (Allied Health Solutions, 2013).

The Paramedic Evidence Based Project (PEEP), which was funded by the College of Paramedics, emphasises the need for a more robust education and training system. As current education and training for paramedics in England is locally determined, very different levels of learning outcomes are being achieved at the point of registration. It has therefore been highlighted that education and training needs to be standardised, and a clear framework enabling this to happen must be developed.

The report proposes a model that would lead to an all-graduate paramedic profession by 2019. It also proposes raising the minimum threshold entry onto the Paramedic Register of the Health and Care Professions Council, so that all student paramedics enrol on programmes leading to a minimum award for a diploma in higher education (DipHE) by September 2015.

But what would an all-graduate profession offer in contrast to the current model? According to Andy Newton, consultant paramedic and director of clinical operations, South East Coast Ambulance Service NHS Foundation Trust: ‘Education of the workforce is a prerequisite for lasting change and the core enabler for changing clinical behaviour’ (Newton, 2013). Two of the most important areas that would hopefully see significant development as a result of an all-graduate workforce are clinical decision-making and critical thinking. As the report quite rightly points out: ‘If the service is demanding a higher level of competence and performance, and we are demanding that paramedics are more autonomous and have more autonomy to make decisions and to keep patients out of hospital, then we have to develop them accordingly’ (Allied Health Solutions, 2013).

In the evolving pre-hospital care landscape, where increases in population and, as a result, 999 calls, has meant more pressure on A&E departments, the need for a workforce that can reduce hospital admissions by providing clinical care on-scene has never been more important. It appears difficult then to dispute the benefit of enabling paramedic practice to become an all-graduate profession if it will help to make this a possibility.

References:

Allied Health Solutions (2013) Paramedics Evidence Based Education Project (PEEP). End of Study Report. Buckinghamshire New University, High Wycombe

Newton A (2012) The ambulance service: the past, present and future. Journal of Paramedic Practice 4(6): 365–8

Taken from Journal of Paramedic Practice, published 7 October 2013.

Report calls for national education and training framework for paramedics

A recent report issued by the Allied Health Professional Health Education Advisory Group (formally the Department of Health’s AHP Professional Advisory Body) has called for the introduction of a national education and training framework for paramedics.

The Paramedic Evidence Based Project (PEEP), which was funded by the College of Paramedics, emphasises the need for a more robust education and training system. As current education and training for paramedics in England is locally determined, very different levels of learning outcomes are being achieved at the point of registration. It has therefore been highlighted that education and training needs to be standardised, and a clear framework enabling this to happen be developed.

The report proposes a model that would lead to an all-graduate paramedic profession by 2019.

Some of the notable recommendations outlined in the report include: a standardised approach to education and training; the need for an agreement of a pre-registration education development model leading to an all-graduate profession; knowledge and skills enhancement; the development of a partnership model; the appointment of a national lead for education and training of paramedics in England; and a standardised approach to identification.

Professor Chris Welsh, Director for Education and Quality for Health Education England, said: ‘We note the recommendations in this report, however we also understand it is not a full account of issues paramedics are facing in relation to education and training. We’ll be working closely with the College of Paramedics and other stakeholders to look at these recommendations and implement those that have the greatest impact on patient care.’

Professor Andy Newton, Chair of the College of Paramedics, said: ‘As sponsors of the report we were delighted to receive this wide-ranging review highlighting many of the issues facing the profession. The College fully endorse the proposed move to graduate entry and believe that this should be achieved in a timely fashion. We believe that having a well-prepared paramedic at the heart of unscheduled urgent and emergency care will be of major benefit to the wider community. The College looks forward to working with Health Education England, educational leaders in Scotland, Wales, and Northern Ireland and other stakeholders on the report’s recommendations.’

Taken from Journal of Paramedic Practice, published 25 September 2013.