Paramedic

Paramedics provide an immediate response to emergency calls that can be both traumatic and medical in origin, and respond to GP referrals and 111 calls

As a paramedic, you'll usually be the first senior autonomous independent healthcare professional on the scene, and the level of care you provide can range from dealing with life-threatening conditions to minor illnesses and injuries.

You'll need to undertake a full medical and health assessment to determine a patient's condition, provide essential treatment and transportation to a designated hospital or care facility.

You'll typically work in a two-person ambulance crew alongside an ambulance technician or emergency care assistant. It's also possible to work alone, using an emergency response car, motorbike or bicycle to get to a patient.

Types of treatment given by paramedics

While paramedics treat up to 50% of medical cases in the patient's home and discuss and negotiate the best optimal outcomes for the patient, sometimes in life-threatening situations a variety of interventions might be required such as:

• resuscitating and stabilising patients
• establishing and maintaining an airway in a stepwise approach
• stopping severe haemorrhage
• using high-tech equipment, such as a defibrillator, pulse oximeters and end-tidal oxygen
• applying spinal and traction splints
• administering intravenous drips, drugs and oxygen.
• working with other emergency services such as the police, fire, coast guard and RNLI.

Responsibilities

Your work will vary greatly depending on the patient and their condition, but in general you'll need to:

• listen to the patient and gain their consent (if possible) before undertaking any assessments and treatment
• provide medical assessments and any immediate course of treatment prior to transporting them to a designated hospital
• use technical equipment, including ventilators to assist breathing and defibrillators to treat heart failure, in order to resuscitate and stabilise
• carry out certain surgical procedures when necessary, such as cannulation to insert a cannula into a large vein and endotracheal intubation (insertion of a breathing tube into the trachea)
• monitor the patient's condition on an ongoing basis
• decide if admission to hospital is necessary and assess how to move patients and where the best location is for them
• liaise with members of other emergency services, such as the police, fire brigade or coast guard, and other ambulance services to ensure the appropriate level of response is provided
• work closely with doctors, midwives and nurses in hospital emergency departments, briefing them as their patient arrives at hospital
• liaise with allied health professionals such as radiographers, physiotherapists, occupational therapists and podiatrists to ensure a team approach to a patient's care journey
• deal with members of the public and negotiate with family members present at the scene
• clean, decontaminate and check vehicles and equipment to maintain a state of operational readiness
• assist other healthcare professionals with patient care in hospitals or health care centres
• provide clinical advice to patients and other colleagues over the telephone from a control room
• produce thorough case notes and report details about the patient's history, condition and treatment to relevant hospital staff
• maintain patient confidentiality and act in a professional manner at all times
• support and supervise student paramedics and new staff.

Salary

• Salaries are covered by the NHS Agenda for Change pay scales. Paramedic salaries start at Band 5, which ranges from £25,655 to £31,534. You'll move up to Band 6 (£32,306 and £39,027) after two years following a newly qualified paramedic pathway.
• For team leaders or senior paramedics who have undertaken extended skills training in critical care or trauma, salaries are at Band 6/7 and fall between £32,306 and £45,839. Paramedics working in primary care or in a GP practice should expect to gain band 7 after a year.
• If you continue to work up to the level of consultant paramedic, you could achieve a Band 8c salary of £65,664 to £75,874.

Employee benefits may include an NHS pension scheme, study leave for sponsored courses, relocation packages and access to counselling services and physiotherapy treatment.

Salaries outside the NHS may vary, depending on the sector and type of organisation.

Figures are intended as a guide only.

Working hours

The emergency ambulance service operates 24 hours a day so you'll need to work shifts to cover this. You'll typically do 37.5 hours per week, which can be made up of evenings and nights, weekends and public holidays.

You may be required for additional stand-by and on-call duties, especially in remote areas.

Flexible working opportunities such as part-time work or job sharing may be available.

What to expect

• You'll often be based at a local ambulance station and will have to respond to calls at any time of the day or night in all types of weather. You might also work in a GP surgery or minor injuries unit.
• Jobs are available in all NHS trust regions throughout the UK.
• Uniforms are worn and protective clothing, such as a high-visibility jacket and boots, may be necessary.
• The work is physically demanding and can be psychologically and emotionally challenging. Particularly as ambulance crews are, at times, exposed to verbal and physical abuse, often due to the increasing number of alcohol-related call-outs. However, you'll receive training in managing conflict and it can be an extremely rewarding role. Debriefing, chaplaincy and counselling systems are in place and stress management courses are available.
• Travel within the working day is a regular feature of the role, not just within your own region but also to partnering trusts when cover might be low. You may finish your shift over an hour away from your base station. Overseas work or travel is unusual.

Qualifications

To work as a paramedic, you must be registered with the Health & Care Professions Council (HCPC), and to register you'll need to complete an HCPC-approved paramedic science qualification.

There are three training routes available depending on your previous qualifications and experience:

• The recommended route is to complete a university paramedic science course at BSc Honours degree level.
• Alternatively, you can apply for a position within an ambulance trust as a student paramedic and study while working. The ambulance services are working with partner universities to provide BSc (Hons) degree apprenticeships.
• If you are a nurse, midwife or allied health professional in England, you can take an MSc pre-registration course (level 7), to gain registration as a paramedic. 

Full details of all HCPC-approved paramedic science qualifications are available on the HCPC register of approved education and training programmes. A number of HCPC-approved programmes are also endorsed by The College of Paramedics. For details, see Endorsed Courses.

To get a place on a BSc (Hons) degree programme you'll typically need two or three A-levels, including a science, as well as five GCSEs, including English language, science and maths at Grade 4 (C) or above. For some courses, you'll need a full UK manual driving licence with C1 (or provisional C1) status.

Student paramedic apprenticeships are very competitive, and each NHS ambulance service trust may have its own individual entry requirements for posts. Check for details in the job advertisement or contact the trust directly for further details. Applicants will usually need five GCSEs, including English language, science and maths at Grade 4 (C) or above, as well as a clean manual driving licence with Category C1 status.

You'll need to undertake an enhanced Disclosure and Barring Service (DBS) check in England and Wales, Access Northern Ireland or the Protecting Vulnerable Groups (PVG) scheme in Scotland to train as a paramedic. A fitness assessment is also a common requirement and an occupational health assessment.

Paramedic students can receive funding support of at least £5,000 per year. There is up to £3,000 further funding available for eligible students. You don't have to pay it back and are still able to access funding for tuition and maintenance loans from the Student Loans Company. For more information, see Health Careers.

For more information on a career as a paramedic, see The College of Paramedics Become a Paramedic.

Skills

You'll need to have:

• excellent interpersonal skills for dealing with patients, their friends and family, and members of the public
• strong teamwork skills to work alongside other crew and hospital staff
• the ability to work autonomously
• oral, written and listening communication skills for reporting conditions
• skills in problem solving and critical thinking
• the ability to remain calm and focused under pressure
• initiative and decision making skills
• a calm and reassuring approach
• a caring attitude and outgoing, helpful personality
• resilience in the face of strong emotions
• integrity and honesty
• a responsible and highly motivated approach to the work
• good general fitness to cope with lifting patients and equipment
• excellent driving skills - most NHS ambulance trusts will require you to be able to drive an ambulance under emergency conditions.

Work experience

You'll usually be expected to have some relevant healthcare or first aid experience, which may include:

• voluntary experience in organisations such as St John Ambulance, St Andrew's First Aid and British Red Cross
• experience in life-saving techniques, which you can gain by volunteering as a community first responder in association with local ambulance services
• experience as an emergency care assistant (supporting paramedics)
• office-based work in an ambulance service.

If possible, see if you can spend time with an ambulance service to show course providers that you understand the role of a paramedic.

A current first aid certificate is also useful as it will show your interest in the work. Other experiences of working with sick, disabled and/or elderly people can also be useful.

It's useful to become a student member of The College of Paramedics. This will show your interest in, and commitment to, the profession and provide access to useful resources.

Find out more about the different kinds of work experience and internships that are available.

Employers

Most paramedics work for the NHS and are recruited and employed in individual NHS trust ambulance services covering specific geographical areas.

Ambulance services are usually committed to having at least one paramedic on each emergency ambulance. Job opportunities are therefore generally good, but the number of vacancies varies between regions across the UK.

There is a growing number of private companies providing ambulance services. They provide a range of services that can include:

• specialist patient transfer
• non-emergency patient journeys
• cover at sporting fixtures, major events or on film and TV sets
• support for NHS trust ambulance services when there is heavy demand.

Other employers include:

• the armed forces
• HM Prison Service
• overseas health departments
• oil and gas exploration companies.

Other opportunities exist as first aid instructors and health and safety trainers.

Look for job vacancies at:

• Jobs.hscni.net - health and social care jobs in Northern Ireland
• NHS Jobs
• NHS Scotland National Recruitment portal
• Welsh Ambulance Services NHS Trust

Private ambulance agencies covering specialist events can be found using internet search engines. Some NHS ambulance services, as well as agencies, operate registers for relief or shift-cover paramedic work.

Professional development

When you join an ambulance service, you'll receive on-the-job training to become familiar with that particular service and will usually have a mentor who is a more experienced paramedic.

After one year of post-registration experience, it's common to be developed as a practice placement educator so that you can also support other students who will work alongside you.

You must be registered with the HCPC to practise as a paramedic and to stay on the register you need to comply with HCPC regulations. This includes undertaking continuing professional development (CPD) and keeping a record of your CPD activities.

Typically, you can continue your development by carrying out:

• formal education
• professional activity
• self-directed learning
• work-based learning.

Activities might include:

• attending conferences
• reading professional publications
• joining a professional specialist interest group
• work shadowing.

You can also take further qualifications at postgraduate level. This might be to progress to a role as a specialist paramedic in urgent and emergency care, for example, or to apply for an advanced paramedic position. Taking a management qualification, part time while working, may help you progress into a management position.

The College of Paramedics provides a post-registration career framework, CPD events and an annual conference. Membership provides benefits including various levels of insurance cover, access to a regional network and different resources and products.

Career prospects

With experience and further training, there are opportunities to move into more senior paramedic roles. In these types of roles, you'll have your own area of responsibility and will be able to make more decisions about treatment, enabling you to treat some patients at the scene of the emergency.

As a senior paramedic it's possible to work as an emergency care practitioner (ECP), where you could be based in:

• community hospitals
• GP surgeries
• health centres
• hospital accident and emergency departments
• minor injuries units.

It's also possible, with further training in critical care and trauma, to move into the senior role of critical care paramedic. Opportunities exist in some locations for specialist work with motorcycle, rapid response car or air ambulance (helicopter) units.

There are opportunities with extensive experience and training to progress into management posts such as operational manager, assistant director of operations or a senior position in the control room.

You may choose to move to related occupations in healthcare, either in a clinical role, such as nursing, or into non-clinical careers, such as NHS trust management and administration, training and development, or health and safety. You'll usually need further training and qualifications.

Careers in other uniformed services, such as the armed forces, police or fire service, are also an option, as are lecturing posts on paramedic science courses.