Roles, Qualifications and Titles.
This is a reoccurring hot topic throughout the UK Ambulance and Event Medical Services and as an industry we are guilty of having no one single, defined route of progression. Wherever you are employed, different qualifications are offered, with different core syllabi offering slightly different skill-sets to reach the same end goal. Although often not important to the general public, who usually thinks that anyone dressed in a green uniform is a “Paramedic”, It’s important for those within the industry to understand what is in a role title and understand the scope of the qualifications backing them up. It’s seen all too often where 'Grand Titles' are used to inflate the ego or the status of a First Aider, which can easily confuse clients, patients and professionals alike.
I would like to start by pointing out for the most part, this does not seem to apply to most of those who hold a professional registration, e.g. Paramedics, Nurses and Doctors. At their most basic levels, their education is universally defined in order to meet registration criteria, and in general skill sets are set against national frameworks. This does become somewhat skewed when you dive into the realms of Nurse Practitioners or Specialist Paramedics, but I feel that’s a path for another blog post to explore.
Where the problem appears to lie, is in the Non Registered grades of people calling themselves, “Emergency Practitioners”, “Advanced Practitioners”, “First Responders”, “Advanced Responders”, “EMT” and the like….. the list goes on. With such an array of qualifications and skill sets available, both trained internally in some organisations and others externally, in conjunction with so many varying medical titles given to people, its often very hard to judge what an individual’s skill set really is. Unfortunately, most of these titles are unprotected unlike that of a Paramedic or Nurse, meaning in theory somebody with a basic first aid qualification could call themselves an “Emergency Practitioner”. In reality this rarely happens in the UK, but unfortunately, we do hear of individuals who often give themselves over inflated medical titles and then find themselves way out of their depth or providing skills and treatments they are not trained or competent in.
In the UK, you would think the NHS would set the gold standard for different medical titles, but unfortunately even this varies from trust to trust. For example the lowest grade you may find on a frontline emergency ambulance is an Emergency Care Assistant, though sometimes called an Emergency Care Support Worker, or an Emergency Vehicle Operative, or an Emergency Transport Attendant….. you get the idea. Moreover, all of these titles still have small differences in what the individual can and cannot do, and all of them carry different qualification paths to the same end result.
This therefore makes it extremely difficult for an individual to choose the most appropriate path of progression and acceptance. There are some qualifications that are more universally recognised like FPOS (First Person On Scene), FREC (First Response Emergency Care), AAP (Associate Ambulance Practitioner), IHCD Technician, but even these are sometimes unacceptable to specific organisations. There is also the ongoing battle between qualifications in the Private, NHS and Charitable sectors all of which have different paths of progression and certificates often being non transferable between the sectors.
One way of somewhat guaranteeing appropriate role titles and skill sets within the independent ambulance sector is through those companies with a CQC registration, as they are bound by a strict set of regulations and code of conduct surrounding medical provision. These private firms often work alongside NHS partners and therefore will have to meet similar or identical criteria in order to do so. Moreover the CQC may look at the qualifications used and accepted by firms as this could have an impact on inspection outcomes. Its therefore in a CQC registered companies’ interest to be more strict on having appropriately qualified staff with appropriate titles and governance to support their skill set.
In the short term there is no immediate solution to tackle this issue as there is no defined national framework unilaterally agreed between all UK entities offering ambulance services. Qualifications do rise and fall in popularity depending on several factors and service requirements. At the moment popularity seems to be shifting towards the FREC suite of courses for basic ambulance crews, Associate Ambulance Practitioners seem to be replacing traditional Ambulance Technicians and the HCPC are have recently announced amended criteria to gain paramedic registration. This of course may all shift in the coming weeks, months and years as goals change and governance keeps adapting. Some do argue for and against specific paths to becoming a Paramedic, for example those that do a 3 year university degree vs those who do top up HNDs from technician qualifications, but again this just proves the many differing paths taken to gain the same end goal.