The ‘Paramedic’ title is protected by UK law and professionals must be registered with the Health and Care Professions Council (HCPC) to use the title and to practice in this role.
This is a great safety net and offers some assurance to event organisers that individuals are both qualified and have accountability for their practice.
That said, just because a Paramedic is registered with the HCPC, does not mean they all have the same training and indeed experience.
As an event organiser, when you are booking a Paramedic for your event, do you ever think how experienced the Paramedic might be?
Newly qualified Paramedics (NQPs) will register via Diploma or Degree level education. Both pathways include classroom theory and practical placements with an Ambulance Trusts.
The clinical exposure can be limited and there is no guarantee that the students will experience and have exposure to everything that is expected of the Paramedic role. So much so that many NQPs will often be seeing conditions and performing interventions for the first time, on their own, after they have qualified.
Thankfully, it is now widely recognised that learning does not end at registration and in fact this is often when the learning really starts.
Experiential learning is a vital phase and one which the NQP should be well supported whilst increasing their knowledge and confidence safely. For this reason, the ambulance trusts in England, national staff side representatives, College of Paramedics and other key stakeholders have devised a two-year consolidation period. This is designed to support NQPs to deliver the scope of practice which the role demands.
The framework contains nationally agreed learning outcomes, which must be evidenced by NQPs in order to progress through the consolidation period. It is aimed at enabling NQPs to demonstrate increasing competence and confidence.
NQPs complete a portfolio with the NHS Trust they are working for. Both the theoretical and practical aspects of the consolidation period will be assessed. In addition to the achievement of specified learning outcomes, competence will also be determined through consolidation in clinical practice.
NQPs will frequently be the first point of contact for service users who present with a wide range of emergency and unscheduled health problems. The framework will evidence autonomous decision-making based on sound clinical judgment, to complete episodes of care in a range of settings when it is safe and appropriate to do so and to manage referrals appropriately when it is not.
The aim is to support NQPs to provide evidence of their journey as a Paramedic, from being new registrants to growing into confident and capable professionals. Evidence of this journey will include the use of continuous learning, reflection and self-audit.
During consolidation, NQPs should be encouraged to seek help, advice and information at any stage while they consolidate their learning and when they are unsure. By the end of the consolidation period Paramedics should be established and verified in the workplace as competent, safe and effective professionals.
What does this mean for event Paramedics?
Well, working as an event Paramedic is challenging. For a start they are often based in unfamiliar environments with unfamiliar equipment and unfamiliar colleagues.
Event Paramedics are often required to work solo and their work is far more autonomous than their work in the NHS, where they are working alongside strict policy and procedure to aid good, safe and effective practice. They are often working for companies who have little or no clinical governance with no scope of practice.
When working for an NHS Ambulance Trust the NQP has open access to a full structure of support. If at any point they are unsure of a decision they are able to call upon a senior clinician both on the phone or face to face. They have a large support network working alongside other colleagues with great knowledge and experience. In the event medical industry, the Paramedic is often the most senior clinician at the event and not only are they clinically responsible they are often supporting a team of untrained or unqualified individuals.
They may or may not be provided with a safe level of equipment and drugs and it is likely that the equipment will be different from what they are used to using in their NHS work.
Often event Paramedics are required to discharge people at the event or refer them for continued care. Paramedics working in the NHS have tools and safety nets to aid them in completing safe discharges but in the event world the clinician is often expected to make decisions based purely on their knowledge and experience. As an NQP this knowledge and experience may not be adequate to ensure this is safe.
Another heightened risk is the staff that are working with the Paramedic. They are often unfamiliar with the Paramedic practice. Whereas in the NHS the Paramedic will be working with other clinicians who work to assist the Paramedic when performing interventions. Even when the Paramedic has a team working with them, they may feel like they are alone as nobody is able to assist.
Back to the event organisers worst nightmare, a cardiac arrest at an event. Arguably the most serious time critical incident any Paramedic will have to deal with. Imagine if this happened at your event and the Paramedic has never had to deal with one before. Do you think the person at your event in cardiac arrest will receive the best possible care from the Paramedic? Debatable.
There are some situations where it is acceptable to use NQPs at your events. For example, when they you are booking more than one Paramedic and they will be working alongside senior more experienced clinicians who can offer advice and support to aid their practice.
In general, the use of NQPs who have been registered under 2 years and have not completed a recognised preceptorship programme should be avoided.
What can you do?
When you make a booking for a Paramedic, state that they must have been registered over 2 years or have completed the NQP preceptorship programme.
Ask for the Paramedics HCPC number.
Check the HCPC online register https://www.hcpc-uk.org/check-the-register/
Ask the provider how many years the Paramedic has been registered.
If they registered less than 2 years ago ask the provider if they have completed their NQP preceptorship programme.
If they have been registered less than 2 years and have not completed their preceptorship programme, then ask the provider for an alternative Paramedic.