Paramedicine is a constantly evolving field, with paramedic education programmes needing to be adaptable to keep up with changes in the scope of practice. Regulatory frameworks are crucial in guiding university programmes, providing students with the knowledge, skills, and professional attributes necessary to be safe and competent practitioners. This study aimed to identify variations in regulatory structures, the factors that influence those variations, and how they influence curricula. A descriptive-comparative approach was taken to examine paramedic accreditation processes, curricula, and syllabi across five countries using a modified Brady's model and extending the Comparative Education model. The findings suggest that paramedic services, regulatory authorities, and tertiary institutions must adopt a multilateral approach to recognise paramedicine's evolving scope of practice. All three stakeholders are responsible for aligning regulatory frameworks with industry needs and providing curricula guidance to tertiary institutions. This approach will enable paramedic education programmes to remain relevant and adaptable to changes in the field, ensuring that graduates are safe and competent practitioners. In conclusion, this study highlights the need for a collaborative effort between paramedic services, regulatory authorities, and tertiary institutions to recognise paramedicine's evolving scope of practice. The need for recognition of this evolution in both regulatory frameworks and curricula is a significant concern, and a multilateral approach is required to address this issue. This study provides valuable insights into the factors that influence variations in regulatory structures and their influence on curricula.
Paramedic clinical practice has seen significant evolution from the traditional role of transporting patients to an emergency department (ED). An evolving and flexible scope of practice, modernisation and healthcare reform has necessitated the development of a range of referral pathways for paramedics, with the aim of ensuring that service users receive the most appropriate care at point of contact. Ambulance conveyance rates to EDs in Northern Ireland (NI) have only occasionally fallen below 75%. A study examining a Northern Ireland Ambulance Service (NIAS) referral pathway showed a much lower referral rate than those of comparable ambulance services. A similar study found that over 70% of people who experience a fall are not referred to falls prevention services. This study aimed to identify what paramedics perceive the barriers and facilitators to the use of appropriate care pathways (ACPs) in NI are.
art of patient care. Medical documentation prevents the loss of information and contributes towards improved ongoing medical care and can be referred to if there is a complaint regarding patients care, for research purposes and quality assurance. The purpose of this research, therefore, is to develop a framework, which can be used to improve the quality of medical documentation completed by PHECPs. This will require the identification of the information and knowledge gaps that PHECPS have regarding medical documentation and the manner in which they complete medical documentation. Solutions to the identified gaps will be provided by interviewing industry experts and reviewing current literature. The identified solutions will be used to create a clinical framework, which can be implemented to improve the quality of medical documentation recorded by PHECPs. This research will utilise a four-phase sequential explanatory mixed methodology. Phase one- quantitative phase: The PHECPS knowledge and perceptions of medical documentation will be assessed using a questionnaire with a quantitative design. Phase two, quantitative phase - Common problems and trends in medical documentation will be identified and quantitatively analysed on completed PRFs using a previously developed tool. Phase three - qualitative phase: Qualitative, semi structured interviews will be conducted to gain a greater understanding of the points identified in phase one and two of the research. Phase four: Assimilation of the data collected in phases 1,2 and 3 will be used to develop a proposed framework to improve MD. Phase four: A Delphi survey will be used to for additional expert input and consensus on the content and design of the framework
This project is in partial fulfilment of a PhD that is exploring the relationship and impact of ethnic diversity and diversity training on cultural competence in frontline ambulance service staff. The first study in this PhD was a review of WRES data from all ten ambulance services in England, in order to gain an understanding of workforce equality. The second study was a scoping review of factors impacting cultural competence in healthcare personnel. This was conducted as the third study (this project) aims to survey frontline ambulance service staff diversity demographics, life experiences, training and cultural competence. However, to understand the relationship between these factors and cultural competence, the other factors impacting cultural competence need to be known and accounted for. The fourth and final study in this PhD (also part of this project), aims to explore frontline service staffs’ acquisition of cultural competence, and their experiences and perspectives of cultural competence, its associated diversity training and importance on professional practice.
This study addresses the overuse of healthcare interventions in UK primary care, which can harm patients and strain healthcare systems. Overuse includes unnecessary tests, treatments, referrals, or diagnoses that are unlikely to benefit patients but could cause harm, such as side effects, psychological distress, or financial burdens. Healthcare professionals (HCPs) face challenges balancing necessary care with avoiding overuse, often due to factors like diagnostic uncertainty, fear of complaints, time pressures, patient expectations, and rigid clinical guidelines. This research explores HCPs’ experiences and perceptions of ‘not doing’, the intentional decision to avoid unnecessary interventions based on patients’ medical needs, values, and preferences. It also examines the under-researched area of documenting such decisions. Current professional guidelines offer limited direction in the documentation of ‘not doing’, and HCPs are often apprehensive about potential repercussions. This study, grounded in social constructivism, uses 40 semi-structured interviews with HCPs, including GPs, Paramedics and Nurses. Participants are recruited through purposive sampling. An interview guide, co-designed with PPI representatives and GP advisors, uses text-based vignettes to prompt discussion. Interviews conducted via video call are audio recorded, transcribed, and analysed using Reflexive Thematic Analysis (RTA) with NVivo software. This method highlights patterns and variations while ensuring reflexivity and rigour.
Scoping review of literature to determine if there is any evidence supporting the PICO question directly and indirectly. Research evidence supporting the intervention of POCUS at a timeline within a patient care episode that would predict or rule in/rule out the need for CT head before clinical signs and symptoms of raised ICP due to mild to moderate TBI manifest.
West Midlands Ambulance Service crews are taking blood and saliva samples at first point of contact with suspected stroke patients. These are then tested in University of Birmingham facilities to see if we can identify stroke biomarkers in these ultra-early samples.
This is a sequential mixed methods, pre and post questionnaire study. Student paramedics from UK based universities will be asked to complete a quantitative questionnaire getting them to self rate their levels of reflection and well-being. They will then be given a digital tool (WRAPT tool) which is an online model of reflection to use whilst on their ambulance placement for a minimum of 4 weeks. After using this tool for a minimum of 4 times, for a minimum of 4 weeks they will then be given the same questionnaire getting them to self rate their levels of reflection and well-being and to rate the usability of the WRAPT tool. This will evaluate if there has been a change in the participants well-being, self insight, and self-reflective abilities after using the WRAPT tool. Based on the results of the questionnaires an interview guide will be created. A sample of participants who completed both questionnaires will be invited to discuss the strengths and weaknesses of the tool, as well as their overall experience.
The demand for mental health support in England has risen sharply in recent years, exceeding the capacity of available services. Approximately 1.2 million people are currently on NHS community mental health waiting lists, placing increased strain on paramedics, who now spend an estimated 1.8 million hours annually responding to mental health-related calls. As frontline responders, paramedics play a critical role in providing urgent care to individuals experiencing mental health difficulties. However, existing research highlights that paramedics tend to feel frustration, uncertainty, and lack of confidence when managing patients with mental health presentations. Despite this, there is currently no standardised mental health education or training requirement for paramedics in England, and limited research has explored the specific knowledge gaps that hinder their ability to provide effective care. This study aims to identify and assess the knowledge gaps and educational needs of paramedics regarding mental health care. Findings will inform the development of targeted educational initiatives, equipping paramedics with the necessary skills to improve patient outcomes and bridge gaps in pre-hospital mental health care.
To adequately prepare graduates for the dynamic demands of paramedic practice, adopting a contemporary educational approach is essential. This involves collaborating to identify crucial competencies through input from industry stakeholders, experienced practitioners, and discipline-specific experts. Accreditation assumes a central role within this framework, serving as a cornerstone to ensure that paramedicine curricula align with paramedics' diverse and evolving professional roles. Methods A narrative review of the literature and a directed search of grey literature were performed to identify specific developments in paramedicine competencies and scope of practice and mapped to the professional capabilities published by the Paramedicine Board of Australia. In determining a competency map and accreditation’s role in a competency framework specific to current and evolving paramedic practice, key documents were analysed using a qualitative approach based on content analysis to identify common traits among documents, countries and other professions. Results The review process identified 278 themes that were further allocated to 22 major analytical groupings. These groupings could further be mapped to previously reported cognitive, technical, integrative, context, relationship, affective/moral competencies and habits of mind. At the same time, the highest-rated groupings were key competencies of intellectual skills, safety, accountability, clinical decision-making, professionalism, communications, team-based approach and situational awareness. Two groups were represented in the literature but not in the professional capabilities, namely Health and Social continuum and self-directed practice. Conclusions This review highlights the importance of measuring and validating the professional capabilities of Paramedicine Practitioners. The study explores various metrics and competency frameworks used to assess competency, comparing them against national accreditation schemes' professional capability standards. The findings suggest that accreditation frameworks play a crucial role in improving the quality of paramedicine practice, encompassing intellectual skills, safety, accountability, clinical decision-making, professionalism, communication, teamwork, and situational awareness.
This research aims to assess the impact of Community First Responder (CFR) involvement on the outcomes of Out-of-Hospital Cardiac Arrest (OHCA) cases within the North East Ambulance Service (NEAS) region. The study will focus on the Return of Spontaneous Circulation (ROSC) rate, alongside secondary outcomes such as bystander interventions and clinical management metrics, comparing CFR-attended and non-CFR-attended cases. It will also examine the specific impact of the Newcastle University First Responder Scheme on OHCA outcomes. The project will analyse routinely collected OHCA data from 2019 to 2024, using a retrospective cohort design. The primary aim is to investigate whether CFR involvement leads to improved ROSC rates and other clinical outcomes. A secondary focus will be on exploring the effectiveness of the Newcastle University CFR scheme within the NEAS region. Building on a 2023 analysis of urban and rural OHCA outcomes, this study will expand the dataset to five years of data. This broader scope will allow for a more detailed exploration of CFR impact, specifically whether CFR intervention is linked to improved ROSC at hospital. The study will use anonymised data from NEAS’s OHCA audit database, including key variables such as CFR dispatch status, bystander CPR, and ROSC rates. Statistical analyses using SPSS will compare outcomes between CFR and non-CFR cases, adjusting for confounders like demographics and response times. The findings will add to the evidence base on the role of CFRs in OHCA care, providing insights into their effectiveness in improving clinical outcomes. These results will inform future initiatives involving CFRs. The research will be disseminated through peer-reviewed publications to the British Paramedic Journal, conference presentations, and internal reports to NEAS and other CFR schemes. This research has received funding from the College of Paramedics small research grant.
When faced with children paramedics (and other healthcare professionals) may have to estimate weight which can be used as a basis for administering drugs. Many estimation techniques rely on the patient’s chronological age however this has been shown to be unreliable (Black et al., 2002; Marlow et al., 2011; Charlton, Capsey and Moat, 2020), and in some cases a patient’s age may be unknown. Other techniques include parental estimation (Krieser et al., 2007) and measuring systems based on height and size (e.g. Braselow tape). Anecdotally paramedics may use a child’s clothing size to estimate age, and thus weight, when this is unknown. It is expected that the findings of this study will be used to improve the safe and effective treatment of children treated by paramedics by informing methods to estimate weight. This study will use a combination of face-to-face and online questionnaires to compare parental estimation, age-based formulae, and clothing size based formulae to establish their accuracy. The reference standard will be that 70% of estimations are within 10% of the actual weight, and 95% are within 20% (Wells et al., 2017).