The study investigates paramedics’ coping actions for sustainable long-term work performance and burnout prevention. The research focuses on what individuals are doing to cope with their day-to-day stressors and the actions they take that may contribute to recovery and be protective against burnout. The research will involve short interviews to collect the data which should take 30 minutes. The interview will be conducted online (e.g. via Microsoft Teams). During the interview, the participant will be asked a series of questions about their experience of their job as a paramedic. Specifically, we will ask about day-to-day responsibilities, how individuals cope with these and if there are any challenges to applying coping strategies. With permission, the interview will be recorded, but participants can choose to keep their cameras off if they wish. Inclusion criteria: current or former practising paramedics, aged 18 and over, who can give informed consent. Exclusion criteria: Paramedic Students or individuals currently diagnosed with and receiving treatment for mental health disorders, such as burnout, mood and anxiety disorders.
The last 4 years has seen England’s ambulance services sustain unprecedented pressure from the operational demand generated by the pandemic. Operational demand remains high, with system failures, low morale, toxic cultures and hazardous environments causing significant wellbeing, and retention problems. Ambulance staff are more likely to develop mental health conditions such as PTSD than any other emergency service, with many ambulance staff also suffering from assaults, and burnout. If ambulance service senior leaders were better connected to the needs of their staff, however, bespoke leadership models/qualities/skills could be introduced to counteract some of the challenges identified. At the time of writing, no UK research that explores what frontline ambulance service staff need from senior leaders by way of support could be found. This, therefore, is core the focus of our investigations: to understand perceptions and experiences of leadership among these staff, and the type of leaders they need to support them during challenging times. Semi-structured interviews (online) were utilised to capture data which allows the research question to be answered.
It is a legal requirement for NHS ambulance trusts to collect patient ethnicity data, and improvements are needed as current adherence is poor. This study aims to interview frontline NHS ambulance staff in England, like paramedics or technicians, who complete ambulance call out documentation to explore the perceived barriers in this specific staff group to collecting this information. It is important to understand these barriers because the lack of patient ethnicity data in ambulance call-out documentation makes it difficult to monitor if health inequalities due to ethnicity exist. Health inequalities are unfair and avoidable difference in health, like when it was reported during the covid19 pandemic that black, Asian and minority ethnic groups were at higher risk of infection, severe symptoms, and death. This link was only found due to routine collection of patient ethnicity data. This study will look for volunteers across up to 10 NHS ambulance services in England who work in frontline roles, specifically those who have face-to-face contact with patients calling 999 and complete ambulance call-out documentation as a result. The study will aim to recruit 20 participants between February and July 2025. Participants will be asked to attend a 60- minute interview online using MS Teams.
This qualitative study is exploring stakeholder perspectives with experience of paramedics working in primary care, on the education and training required to work effectively as a paramedic in primary care settings, establishing whether paramedics have the appropriate education, training, and skills and whether this model is sustainable.
A multicentre, explanatory sequential mixed methods study. Phase 1 consists of an online survey and phase 2 involves semi-structured interviews with key stakeholders from UK NHS ambulance services in order to explore the perceptions and views of ambulance service staff on research culture and capacity building.
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.
Ambulance clinicians often encounter challenging situations involving patient deaths and serious accidents, requiring them to provide bereavement care to affected families. However, research indicates that many ambulance clinicians feel unprepared for this role, citing a lack of formal training in breaking bad news (BBN) and managing bereavement. This can lead to significant emotional strain, impacting their mental health, professional performance, and personal lives. Existing coping strategies and training protocols, such as SPIKES and GRIE_VING, have shown some promise but are not widely known or implemented in pre-hospital care. This study aims to address these challenges by exploring the perspectives and practices of ambulance clinicians in the North East Ambulance Service (NEAS) regarding bereavement care. The research seeks to understand how clinicians perceive their role in supporting families and to identify potential improvements in bereavement care delivery, both for the families and for the clinicians themselves. The study employs a mixed-methods approach. It will begin with a quantitative survey of NEAS clinicians to gather insights into their current bereavement care practices. This will be followed by focus group discussions to explore their experiences in greater depth. Participants will include frontline NEAS ambulance clinicians who have encountered bereavement care situations in the past five years. Findings from this research will provide valuable insights into the realities of bereavement care in pre-hospital settings and help to inform evidence-based strategies for training and support. Ultimately, the goal is to enhance bereavement care for families and better equip ambulance clinicians for this critical aspect of their role.
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 will explore how real-time feedback affects ambulance clinicians’ ability to perform ventilations during a simulated cardiac arrest scenario over six months. Ventilations, typically given via a bag-valve-mask (BVM), are a basic life support skill performed by paramedics in emergency situations, but evidence suggests that many clinicians struggle to deliver ventilations according to guidelines. Feedback during training can help improve these skills, but without regular updates or refresher training, the skills may deteriorate over time. The study will involve participants from a single ambulance service, randomly assigned to three groups. All of these groups will participate in a simulation using a resuscitation manikin. The first group will receive feedback on their ventilations at every session, the second will receive feedback only at the first session, and the third will receive no feedback and act as a control. Ventilation rates and volumes will be measured using a Zoll X-series monitor, which provides real-time feedback. The main aim of the study is to compare the quality of ventilations at the six-month mark between the three groups. A secondary focus will be tracking any changes in ventilation quality across the six months, to identify potential skill improvements or fade.
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.
This study explores how family members experience and perceive bereavement care provided by the ambulance service when a loved one dies in the pre-hospital setting. Bereavement care refers to the support provided to families after the death of a loved one. The study aims to understand what families need during this time and how ambulance services can improve their support. We will invite people who, in the past two years, have lost a family member while receiving care from the ambulance service. This includes cases where the patient died at the scene or shortly after being transported to the hospital. The two-year time frame ensures that experiences reflect current practices, without focusing on care during the COVID-19 pandemic. Participants will be interviewed either in person at a local ambulance service site or online via Microsoft Teams. The interviews will explore family members' experiences and what they felt was helpful or could have been done differently. Each interview will last between 30 and 60 minutes, and all responses will be anonymised to protect participants’ privacy. The results will be analysed to identify themes about what families value and need during this difficult time. This will help the ambulance service improve how it supports grieving families. We will recruit participants through posters in healthcare settings, social media, and partnerships with bereavement charities. Participation is voluntary, and people can withdraw at any point up to 24 hours after the interview. The study aims to highlight family members’ voices to ensure bereavement care is compassionate and meets their needs. Findings will be shared with the ambulance service and published to improve care standards.
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.